Masanobu Imai

PATHOLOGICAL STUDIES ON A LONG-TERM SURVIVED CASE OF GAMMA HEAVY CHAIN DISEASE

A pathological and brief clinical study on the eleventh case of gamma heavy chain (γ‐chain) disease who died at the age of 44 after a long course of 12 years from the assumed onset of the disease was presented. Clinico‐pathological observations of the case showed a neoplastic nature which caused her death complicated by asthmatic sttacks. Autopsy findings were characterized by diffuse infiltration of lymphoplasmacytoid cells and a few large immunoblastic cells into various organs. Literatures of 30 cases reported in the past, and the modern concept of lymphoma strongly suggest that the classiflcatory position of γ‐chain disease as well as Waldenströms macroglobulinemia should be placed between multiple myeloma and classic malignant lymphoma as an independent disease entity belonging to the same category. A proposal of histological typing of the disease was made in order to simplify various diagnostic designations in the literatures:—γ‐ chain disease, 1) reticular type, 2) lymphocytic predominance, 3) plasmacytic predomi nance, 4) lymphoplasmacytoid cell type, 5) immunoblastic type. The present case belongs to type 4.