ASK Meeting 2002

ǥ       020624    020506     020128      011123   


(2002 10 28, Zﺴ)

Zﺴ

    : 54 ȯڷ Ϲװ˻ ̻Ұ ߰ߵǾ Ͽ. » 8 diffuse large B cell lymphoma ܹ޾ ׾ġḦ ¿. Ͽ CBC ˻ 41,300-9.5/28.5-201K (꿡 ̼ 22%)  ˻縦 Ͽ. ˻ , 鿪ǥ ˻(immunophenotyping) ü ˻絵 Ͽ.

 

 

    [ ]

    Diffuse large B cell lymphoma ܿ Ϲ ʴ Ұ߰ ΰ?

       CD5(+) in lymphoma - CLL/SLL

                                     - Mantle cell lymphoma

                                     - CD5(+) DLBCL

        DLBCL CD5(+) Ϲ Ұ ƴϸ, CD5(+) DLBCL̴.


    Zﺴ

    ȣ ϴٴ ּҷ 45 ȯ CBC ˻翡 Ұ ߰Ǿ ˻縦 l 90% ٹ߼ ޾Ҵ. ȯ protein/albumin immunoglobulin Ʒ . Immunoglobulin Beckman Immage Analyzer ̿Ͽ Nephelometry Ͽ ˻ ̴.

     

    T-PROTEIN: 10.8 g/dL

    ALBUMIN :3.5 g/dL

    GLOBULIN :7.3 g/dL

    IgG : 365 mg/dL (ġ: 694-1618 mg/dL)

    IgA : 7,020 mg/dL (ġ: 68-378 mg/dL)

    IgM : 15.1 mg/dL (ġ: 60-263 mg/dL)

    kappa light chain: 300 mg/dL (ġ: 574-1276 mg/dL)

    lambda light chain: 2,610 mg/dL (ġ: 269-638 mg/dL)

    [ ] 

     

    Immunoglobulin ˻ intact immunoglobulin (IgG, IgA IgM) հ light chain (kappa lambda light chain) ̸ ؼؾ ΰ?

    - A monoclonal immunoglobulin has only some of determinants with which the antibodies in    the antiserum usually react, and thus the standard dilution curve does not apply.

       The few antibodies in the antiserum that do react are soon precipitated, and the paraprotein    overestimated. ---- Tietz 3rd edition page 528.

    ܿ Analytic error - prozome or post zone phenomenon

          False aggregates - light chain aggregates

                                    - heavy chain aggregates

          Altered immunoglobulin - free fragments of heavy chain

                                            - epitope loss ִ.

       

    [ : ѸǴ   迵ö]