Kolikkat Nejima, Moideen Shamsudeen, Khader Aysha, Mohammed T P, Uvais N A
Department of Pathology, Iqraa International Hospital and Research Centre, Calicut, Kerala, India.
Department of Internal Medicine, Iqraa International Hospital and Research Centre, Calicut, Kerala, India.
J Family Med Prim Care. 2020 Mar 26;9(3):1768-1771. doi: 10.4103/jfmpc.jfmpc_972_19. eCollection 2020 Mar.
Waldenstrom's macroglobulinemia (WM) is a rare and slowly progressive disorder, a variant of lymphoplasmacytic lymphoma, which needs therapy only when patient becomes symptomatic. WM presents usually with constitutional symptoms, organomegaly, cytopenias, and hyperviscosity syndrome. This neoplasm is composed of small lymphocytes, plasmacytoid lymphocytes, and plasma cells that typically involve the bone marrow, and it is associated with an immunoglobulin M (IgM) gammopathy. Here we report the case a 60-year-old male with WM who initially presented with anemia and fatigue. The patient had no lymphadenopathy or any organomegaly. The diagnosis of WM was made after morphological and immunohistochemical examination of bone marrow of the patient along with an elevated serum IgM level. The patient responded well to plasmapheresis and chemotherapy. This case is unusual because the patient lacked the common clinical features of WM. A thorough clinical and hematological work up including serum electrophoresis, bone marrow study, and immunohistochemistry helps in distinguishing WM from other lymphomas and plasma cell dyscrasias.
华氏巨球蛋白血症（WM）是一种罕见且进展缓慢的疾病，是淋巴浆细胞淋巴瘤的一种变体，仅在患者出现症状时才需要治疗。WM通常表现为全身症状、器官肿大、血细胞减少和高黏滞综合征。这种肿瘤由小淋巴细胞、浆细胞样淋巴细胞和浆细胞组成，通常累及骨髓，并与免疫球蛋白M（IgM）丙种球蛋白病相关。在此，我们报告一例60岁患有WM的男性患者，最初表现为贫血和疲劳。该患者无淋巴结病或任何器官肿大。对患者骨髓进行形态学和免疫组化检查并结合血清IgM水平升高后，确诊为WM。该患者对血浆置换和化疗反应良好。此病例不寻常，因为患者缺乏WM的常见临床特征。包括血清电泳、骨髓检查和免疫组化在内的全面临床和血液学检查有助于将WM与其他淋巴瘤和浆细胞发育异常相鉴别。
