Department of Pathology, University of Oklahoma Health Sciences Center
A 54 year-old man with bilateral enlargement of submandibular glands and proteinuria.
Clinical information: The patient was a 54 year-old male presented with bilateral enlargement of the submandibular glands. He also had a seven month history of proteinuria, hemorrhagic cutaneous blisters, dryness of the eyes and mouth, and a negative serology for autoimmune diseases. The patient had serum protein electrophoresis which showed decreased gamma globulins, with no monoclonal spike; beta-2-microglobulin was slightly elevated. Immunofixation on a random urine specimen showed monoclonal free light chains (Bence Jones protein), kappa type. Physical examination revealed bilateral, firm enlarged submandibular glands (each of maximum dimension approximately 4.0 cm). A fine needle aspiration (FNA) of the right submandibular gland was performed. Representative images are illustrated as follows:
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Cases of the Month Coordinator: KarMing-Fung@ouhsc.edu