Open AccessWaldenstroms Macroglobulinemia Patient Presenting with Rare ‘lytic’ Lesions and Hypercalcemia: A Diagnostic Dilemma
Author(s) -
Khalid Mehmood,
Iftikhar Haider Naqvi,
Syed Raza Shah,
Nazia Zakir,
Syed Mustafa Ali
Publication year - 2014
Publication title -
journal of clinical and diagnostic research
Language(s) - English
Resource type - Journals
eISSN - 2249-782X
pISSN - 0973-709X
DOI - 10.7860/jcdr/2014/8184.5161
Subject(s) - medicine , lytic cycle , bone marrow , waldenstrom macroglobulinemia , pathology , multiple myeloma , skeletal survey , macroglobulinemia , chemotherapy , rare disease , lymphoplasmacytic lymphoma , radiology , disease , lymphoma , immunology , virus
Waldenstroms macroglobulinemia (WM) is an uncommon B-cell lymphoproliferative neoplasm characterized by lymphoplasmacytic cells infiltrating the Bone Marrow, along with demonstration of an IgM monoclonal gammopathy in the serum. Lytic lesions are considered one of the basis for differentiating a patient of Multiple Myeloma (MM) and WM. However, very few cases have been reported with a patient presenting with lytic lesions in a WM patient, thereby, complicating the disease. By finding the extent of these lytic lesions and bone involvement, Not only can we signify the presence or absence of bone lesions, but we can also direct the more efficient use of skeletal X-rays for documentation of the extent, location, and response of bone abnormalities to interventional chemotherapy and radiation therapy. Our case was mimicking the classic case of MM. Using the International Criteria for diagnosis for WM, diagnosis for MM was excluded and diagnosis for WM was made. After two weeks of therapy, the patient showed marked clinical improvement.