Waldenstrom’s Macroglobulinaemia with Villous Lymphocytes

Abstract

Waldenström’s Macroglobulinemia (WM) is a chronic B-cell lymphoproliferative disorder with bone marrow infiltration with small lymphocytes, lymphoplasmacytoid cells and plasma cells and presence of IgM paraprotein in the serum. We report here a case of a 63 years old male patient, who presented with chronic back pain. The pain was initially thought to be due to disc prolapsed, but on further examination of successive bone-marrow aspirations and biopsies and serum electrophoretogram, proved to be WM. The B cell lymphoproliferative disorders are indolent and include Splenic Lymphoma with Villous Lymphocytes (SLVL), Chronic Lymphocytic Leukaemia (CLL) with IgM paraprotein, and Splenic Marginal Zone Lymphoma (SMZL) and Waldenstrom’s macroglobulinaemia. They can be differentiated on the basis of levels of paraprotein, lymphocytic morphology, and degree of marrow involvement in relation to spleen size, as the malignant cells have the same phenotype in this group of diseases which has been highlighted in the index case.

Keywords

• lymphoplasmacytes
• monoclonal gammopathy
• villous lymphocytes