Dhakal Prajwal, Bhatt Vijaya Raj, Upadhyay Smrity, Khanal Nabin, Ganti Apar Kishor
Department of Medicine, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
Department of Internal Medicine, Division of Hematology-Oncology, University of Nebraska Medical Center, Omaha, NE, USA.
World J Oncol. 2014 Aug;5(4):175-177. doi: 10.14740/wjon837w. Epub 2014 Aug 25.
Hyperviscosity syndrome is usually seen in Waldenstrom macroglobulinemia with the serum viscosity > 4 cP. It commonly manifests as skin or mucosal bleeding, visual abnormalities and neurological symptoms. We describe a case of a 65-year-old man, who presented with chronic exertional chest pain and dyspnea without other manifestation and had hyperviscosity syndrome related to marginal zone lymphoma (MZL) even with a marginally elevated plasma viscosity. The symptoms resolved after initiation of chemotherapy. This case illustrates that MZL can cause hyperviscosity syndrome, which can manifest with cardiopulmonary symptoms without other clinical features even at a marginally elevated plasma viscosity. Atypical cases of hyperviscosity syndrome can, thus, present diagnostic challenges and require a high index of suspicion.
高黏滞综合征通常见于血清黏度>4厘泊的华氏巨球蛋白血症。其常见表现为皮肤或黏膜出血、视觉异常和神经症状。我们报告一例65岁男性，他表现为慢性劳力性胸痛和呼吸困难，无其他表现，即使血浆黏度仅轻度升高，也患有与边缘区淋巴瘤（MZL）相关的高黏滞综合征。化疗开始后症状缓解。该病例表明，MZL可导致高黏滞综合征，即使血浆黏度仅轻度升高，也可表现为心肺症状而无其他临床特征。因此，高黏滞综合征的非典型病例可能带来诊断挑战，需要高度怀疑。
