Zhao Huiying, Qin Ling, Wang Geng, Li Jianying, Huang Yuan, Niu Jie, Qin Xuzhen
Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China.
Department of Infectious Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, People's Republic of China.
Cancer Manag Res. 2024 Dec 4;16:1705-1714. doi: 10.2147/CMAR.S486584. eCollection 2024.
Waldenström macroglobulinemia (WM) is a relatively rare hematological malignancy characterized by serum monoclonal IgM gammopathy and bone marrow infiltration of lymphoma cells (small B lymphocytes, plasmacytoid lymphocytes, or plasma cells). Elevated CA125 is most seen in ovarian cancer or some benign diseases such as pelvic inflammatory disease and endometriosis. No cases of WM combined with elevated CA125 have been reported so far. Here, we report two rare cases of WM with abnormally high CA125 at the onset of illness. Patient 1 had a nine-year history of pulmonary shadow with a moderately increased CA125 level. Subsequently, she was diagnosed with WM-related lung involvement by biopsy. Patient 2 presented with WM manifestation and a significantly elevated CA125 level of unknown significance. Based on bone marrow smear results and serum IgM levels, the diagnosis of WM was established in both patients. After rigorous physical examination, imaging screening, and pathological biopsy, any underlying disease associated with elevated CA125 in both patients was excluded. CA125 and IgM levels decreased with effective treatment for WM, suggesting that abnormally elevated CA125 was related to the progression of macroglobulinemia. Suspicious WM patients with elevated serum CA125 of unknown significance need to be alert to a special manifestation of macroglobulinemia. More clinical concern is needed. At the same time, the clinician could monitor the patient's serum CA125 level changes to assist in the judgment of the efficacy of the original disease. This report extends the understanding of WM and the application of CA125.
华氏巨球蛋白血症（WM）是一种相对罕见的血液系统恶性肿瘤，其特征为血清单克隆IgM丙种球蛋白病以及淋巴瘤细胞（小B淋巴细胞、浆细胞样淋巴细胞或浆细胞）浸润骨髓。CA125升高多见于卵巢癌或一些良性疾病，如盆腔炎和子宫内膜异位症。目前尚无WM合并CA125升高的病例报道。在此，我们报告两例罕见的WM病例，其发病时CA125异常升高。病例1有9年肺部阴影病史，CA125水平中度升高。随后，经活检诊断为WM相关的肺部受累。病例2表现为WM症状，CA125水平显著升高，原因不明。根据骨髓涂片结果和血清IgM水平，两名患者均确诊为WM。经过严格的体格检查、影像学筛查和病理活检，排除了两名患者中与CA125升高相关的任何潜在疾病。WM有效治疗后，CA125和IgM水平下降，提示CA125异常升高与巨球蛋白血症的进展有关。血清CA125升高但原因不明的可疑WM患者需要警惕巨球蛋白血症的特殊表现。需要更多的临床关注。同时，临床医生可以监测患者血清CA125水平的变化，以协助判断原发病的疗效。本报告扩展了对WM和CA125应用的认识。
