Waldenström macroglobulinaemia
Description
- Lymphoplasmacytic lymphoma + IgM paraprotein - both required
- An indolent B-cell lymphoma that behaves like a plasma cell disorder
- Symptoms come from three separate sources - separate them, they need different treatment
- Tumour infiltration - cytopenias, nodes, spleen, liver
- IgM as a protein - hyperviscosity, cryoglobulinaemia, cold agglutinins, amyloid
- IgM as an autoantibody - anti-MAG neuropathy, Bing-Neel (CNS)
- *No lytic bone lesions, no hypercalcaemia, renal failure uncommon* - the discriminator from myeloma
- Smouldering / asymptomatic WM - marrow disease + IgM, no symptoms. Observe
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