Lymphoid Interstitial Pneumonia with Dysproteinemia: Report of Two Cases with Plasma Cell Predominance

Abstract

The cases of two patients with prolonged courses of a distinctive combination of cough, shortness of breath, diffuse and nodular pulmonary infiltrates, severe hypergammaglobulinemia with elevated total protein levels, and plasmacytic and lymphocytic infiltration of the lungs are reported. We do not know whether this combination of symptoms and findings constitutes a separate, previously unrecognized entity or whether these cases are part of a spectrum of chronic pulmonary disease in which an unusual number of plasma cells is responsible for the high gamma globulin levels. On the basis of the clinical and pathologic findings, including an autopsy in one case, and the electrophoretic studies, we believe these cases probably represent a chronic inflammatory reaction to some undetermined stimulant rather than an unusual form of multiple myeloma, and that they should be classified as an unusual form of lymphoid interstitial pneumonia.