Waldenstrom macroglobulinemia (WM) is a subset of
lymphoplasmacytic lymphoma and is categorized under mature B-cell lymphoid
neoplasm. This lymphoproliferative disorder is characterized by infiltration of
the bone marrow by a clonal lymphoplasmacytic infiltrate (≥10%) and an IgM
monoclonal gammopathy. WM infiltrate comprises B–lineage cells with
predominance of small lymphocytes, admixed with lymphoplasmacytoid cells,
plasma cells and often increased mast cells. This similar spectrum of cells,
which is present in the bone marrow, may be present in the peripheral blood as
well. With marked plasmacytic differentiation, it may be challenging to
differentiate it from plasma cell leukemia. However, this differentiation is
crucial for prognostication and therapeutic decision-making. We present a case
that manifested with fatigability and dyspnoea, and was misdiagnosed as plasma
cell leukemia on peripheral blood film and bone marrow morphology. It finally
turned out to be a case of Waldenstrom macroglobulinemia on cytoflorometry,
highlighting the role of
elaborated workup and ancillary techniques to direct the accurate diagnosis and
management.
Author (s) Details
Dr. Bhawna Sethi,
Department of Pathology, Shaheed Hasan Khan Mewati, Government Medical College, Nuh, Haryana, India.
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Book :- http://bp.bookpi.org/index.php/bpi/catalog/book/203Department of Pathology, Shaheed Hasan Khan Mewati, Government Medical College, Nuh, Haryana, India.
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