Macroamylase in the pleural fluid of a patient with lymphoma.

A patient with a macroamylase in pleural fluid is described. A diagnosis of recurrent pleural effusion due to chronic relapsing pancreatitis had been made on the basis of hyperamylasemia, high pleural fluid amylase, and abdominal pain. The amylase in the pleural fluid as well as the serum was ultimately characterized as a macroamylase on electrophoresis and chromatography. A diagnosis of lymphoma subsequently became obvious. The pathogenesis of the macroamylase in the pleural effusion and the association of macroamylasemia with malignant disease is discussed.