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A 70-year-old woman with Waldenström's macroglobulinemia (WMG) limited to mediastinal lymph nodes is described. The long-term course of 9 years was uneventful with the combination chemotherapy including cyclophosphamide, vincristine, 6-mercaptopurine and prednisolone. In WMG pleuropulmonary involvement is generally seen as a part of multisystemic disease. However, the cases showing pleuropulmonary manifestations as the sole initial clinical symptom have been rarely reported. In the present case WMG has been localized in the mediastinal lymph nodes during the period of 9 years. This appears the first case of a localized form of WMG which involved lymph nodes in the mediastinum without lung lesion.

Localized form of Waldenstroem's macroglobulinemia. Long-term follow-up study.