Successful Surgical Treatment for Pulmonary Crystal-Storing Histiocytosis Following the Onset of Gastric Non-Hodgkin Lymphoma

Noriaki Kawano; Kiichiro Beppu; Mayumi Oyama; Daisuke Himeji; Shuro Yoshida; Takuro Kuriyama; Nobuyuki Ono; Hiroyuki Masuyama; Kiyoshi Yamashita; Kenichiro Yamaguchi; Yoshiya Shimao; Koichi Oshima; Yuji Ueda; Akira Ueda

doi:10.3960/jslrt.53.241

Case Study

Successful Surgical Treatment for Pulmonary Crystal-Storing Histiocytosis Following the Onset of Gastric Non-Hodgkin Lymphoma

Noriaki Kawano, Kiichiro Beppu, Mayumi Oyama, Daisuke Himeji, Shuro Yoshida, Takuro Kuriyama, Nobuyuki Ono, Hiroyuki Masuyama, Kiyoshi Yamashita, Kenichiro Yamaguchi, Yoshiya Shimao, Koichi Oshima, Yuji Ueda, Akira Ueda

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Noriaki Kawano
Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital
Kiichiro Beppu
Department of Surgery, Miyazaki Prefectural Miyazaki Hospital
Mayumi Oyama
Department of Surgery, Miyazaki Prefectural Miyazaki Hospital
Daisuke Himeji
Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital
Shuro Yoshida
Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital
Takuro Kuriyama
Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital
Nobuyuki Ono
Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital
Hiroyuki Masuyama
Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital
Kiyoshi Yamashita
Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital
Kenichiro Yamaguchi
Department of Radiology, Miyazaki Prefectural Miyazaki Hospital
Yoshiya Shimao
Department of Pathology, Miyazaki Prefectural Miyazaki Hospital
Koichi Oshima
Department of Pathology, Kurume University
Yuji Ueda
Department of Surgery, Miyazaki Prefectural Miyazaki Hospital
Akira Ueda
Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital

Keywords: gastric non-Hodgkin lymphoma, pulmonary crystal-storing histiocytosis, surgical treatment

JOURNAL FREE ACCESS

2013 Volume 53 Issue 3 Pages 241-245

DOI https://doi.org/10.3960/jslrt.53.241

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Abstract

Crystal-storing histiocytosis is a rare clinical entity characterized by an increase in the number of abnormal histiocytes accompanied by accumulation of crystallized immunoglobulins. We describe the case of an 80-year-old man who presented with crystal-storing histiocytosis of the lung 13 years after receiving a diagnosis of gastric non-Hodgkin lymphoma (NHL ; clinical stage, Lugano IA). After wedge resection of the left upper lobe, the histological findings showed crystal-storing histiocytosis with CD68⁺, some small to medium lymphoid cells with CD79a⁺ with κ^+(weekly) and λ^-, and some plasma cells with CD138⁺, and rearrangement of the immunoglobulin heavy chain. Based on the nonrecurrent gastric NHL, small B-cell population, and failure to detect the same clone by polymerase chain reaction analysis, our case was classified as pulmonary localized crystal-storing histiocytosis without underlying lymphoproliferative or plasma cell disorder. The findings of minor B-cell populations harboring a heavy chain rearrangement with slight light-chain restriction (κ > λ) may be related to the pathogenesis of crystallogenesis and crystal-storing histiocytosis. Moreover, surgical treatment may be an effective therapeutic option for solitary crystal-storing histiocytosis. [J Clin Exp Hematop 53(3) : 241-245, 2013]

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