Lymphoplasmacytic lymphoma history and symptoms: Difference between revisions

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{{CMG}}; {{AE}}{{S.M.}}  
{{CMG}}; {{AE}}{{S.M.}}  
==Overview==
==Overview==
Many patients with Waldenström macroglobulinemia are [[asymptomatic]]. The disease is subtle and symptoms are nonspecific. The most common symptoms of Waldenström macroglobulinemia include [[weakness]], [[anorexia]], [[Blurred vision|blurry vision]], [[peripheral neuropathy]], and [[weight loss]]. Less common symptoms of the disease include [[bleeding]] and [[Raynaud's phenomenon|Raynaud phenomenon]].
Many [[patients]] with [[lymphoplasmacytic lymphoma]] are [[asymptomatic]]. The [[disease]] is subtle and [[symptoms]] are nonspecific and are [[Causes|caused]] by [[tumor]] [[Infiltration (medical)|infiltration]], [[Circulatory|circulating]] [[Monoclonal antibody|monoclonal]] [[IgM]], [[IgM]] [[Deposition (physics)|deposition]] into [[tissues]], [[amyloidogenic]] properties of [[IgM]], and [[autoantibody]] [[Activity (chemistry)|activity]] of [[IgM]]. The most common [[symptoms]] of [[lymphoplasmacytic lymphoma]] include [[weakness]], [[anorexia]], unexplained [[weight loss]], [[fever]], [[heavy sweating]], [[Blurred vision|blurry vision]], [[peripheral neuropathy]], and [[abdominal pain]]. Less common [[symptoms]] of the [[disease]] include [[enlarged lymph nodes]], [[abdominal distension]], [[headache]], painless [[Lump|lumps]], [[Raynaud's phenomenon|raynaud phenomenon]], [[altered mental status]], [[mucosal bleeding]], [[vision problems]], [[kidney]] issues, [[heart]] problems, [[infections]], [[Gastrointestinal tract|GIT]] problems, and other [[symptoms]] due to [[cryoglobulinemia]], [[cold agglutinin disease]], [[hyperviscosity syndrome]], and [[Bing-Neel syndrome|bing-neel syndrome]].  


==History and Symptoms==
==History and Symptoms==
=== History ===
=== History ===
* The onset of Waldenström macroglobulinemia is insidious and non-specific.
* The onset of [[lymphoplasmacytic lymphoma]] is insidious and non-specific.
* Approximately 25% of patients with WM are asymptomatic upon presentation; their diagnosis is often made [[Incidental finding|incidentally]] from routine blood tests done for some other reason. WM found this way is sometimes called asymptomatic or Smoldering WM (SWM).<ref name="pmid11736938">{{cite journal| author=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A et al.| title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. | journal=Br J Haematol | year= 2001 | volume= 115 | issue= 3 | pages= 575-82 | pmid=11736938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11736938  }} </ref>
* Approximately 25% of [[patients]] with [[Lymphoplasmacytic lymphoma|LPL]] are [[asymptomatic]] upon [[Presentation (Obstetrics)|presentation]]; their [[diagnosis]] is often made [[Incidental finding|incidentally]] from routine [[blood tests]] [[done]] for some other [[Reasoning|reason]]. [[Waldenström's macroglobulinemia|WM]] found this way is sometimes called [[asymptomatic]] or Smoldering WM (SWM).<ref name="pmid11736938">{{cite journal| author=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A et al.| title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. | journal=Br J Haematol | year= 2001 | volume= 115 | issue= 3 | pages= 575-82 | pmid=11736938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11736938  }} </ref>
* Symptoms develop depending on the tissues involved in the malignant cell infiltration or [[IgM]] deposition.<ref name="pmid10623712">{{cite journal| author=Dimopoulos MA, Panayiotidis P, Moulopoulos LA, Sfikakis P, Dalakas M| title=Waldenström's macroglobulinemia: clinical features, complications, and management. | journal=J Clin Oncol | year= 2000 | volume= 18 | issue= 1 | pages= 214-26 | pmid=10623712 | doi=10.1200/JCO.2000.18.1.214 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10623712  }} </ref>
* [[Symptoms]] develop depending on the [[tissues]] involved in the [[malignant]] cell [[Infiltration (medical)|infiltration]] or [[IgM]] [[Deposition (physics)|deposition]].<ref name="pmid10623712">{{cite journal| author=Dimopoulos MA, Panayiotidis P, Moulopoulos LA, Sfikakis P, Dalakas M| title=Waldenström's macroglobulinemia: clinical features, complications, and management. | journal=J Clin Oncol | year= 2000 | volume= 18 | issue= 1 | pages= 214-26 | pmid=10623712 | doi=10.1200/JCO.2000.18.1.214 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10623712  }} </ref>
=== Manifestations of WM ===
=== Manifestations of Lymphoplasmacytic lymphoma ===
Following is a list of WM manifestations with attributable causes:<ref name="pmid15735132">{{cite journal| author=Dimopoulos MA, Kyle RA, Anagnostopoulos A, Treon SP| title=Diagnosis and management of Waldenstrom's macroglobulinemia. | journal=J Clin Oncol | year= 2005 | volume= 23 | issue= 7 | pages= 1564-77 | pmid=15735132 | doi=10.1200/JCO.2005.03.144 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15735132  }} </ref><ref name="DimopoulosPanayiotidis2000">{{cite journal|last1=Dimopoulos|first1=Meletios A.|last2=Panayiotidis|first2=Panayiotis|last3=Moulopoulos|first3=Lia A.|last4=Sfikakis|first4=Petros|last5=Dalakas|first5=Marinos|title=Waldenström’s Macroglobulinemia: Clinical Features, Complications, and Management|journal=Journal of Clinical Oncology|volume=18|issue=1|year=2000|pages=214–214|issn=0732-183X|doi=10.1200/JCO.2000.18.1.214}}</ref><ref name="pmid3110508">{{cite journal| author=Kyle RA, Garton JP| title=The spectrum of IgM monoclonal gammopathy in 430 cases. | journal=Mayo Clin Proc | year= 1987 | volume= 62 | issue= 8 | pages= 719-31 | pmid=3110508 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3110508  }} </ref><ref name="pmid12883242">{{cite journal| author=Lin P, Bueso-Ramos C, Wilson CS, Mansoor A, Medeiros LJ| title=Waldenstrom macroglobulinemia involving extramedullary sites: morphologic and immunophenotypic findings in 44 patients. | journal=Am J Surg Pathol | year= 2003 | volume= 27 | issue= 8 | pages= 1104-13 | pmid=12883242 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12883242  }} </ref><ref name="pmid8123836">{{cite journal| author=Dimopoulos MA, Alexanian R| title=Waldenstrom's macroglobulinemia. | journal=Blood | year= 1994 | volume= 83 | issue= 6 | pages= 1452-9 | pmid=8123836 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8123836  }} </ref><ref name="pmid6767276">{{cite journal| author=Fudenberg HH, Virella G| title=Multiple myeloma and Waldenström macroglobulinemia: unusual presentations. | journal=Semin Hematol | year= 1980 | volume= 17 | issue= 1 | pages= 63-79 | pmid=6767276 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6767276  }} </ref><ref name="pmid9671845">{{cite journal| author=Fadil A, Taylor DE| title=The lung and Waldenström's macroglobulinemia. | journal=South Med J | year= 1998 | volume= 91 | issue= 7 | pages= 681-5 | pmid=9671845 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9671845  }} </ref><ref name="pmid9198063">{{cite journal| author=Veltman GA, van Veen S, Kluin-Nelemans JC, Bruijn JA, van Es LA| title=Renal disease in Waldenström's macroglobulinaemia. | journal=Nephrol Dial Transplant | year= 1997 | volume= 12 | issue= 6 | pages= 1256-9 | pmid=9198063 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9198063  }} </ref><ref name="pmid10188670">{{cite journal| author=Daoud MS, Lust JA, Kyle RA, Pittelkow MR| title=Monoclonal gammopathies and associated skin disorders. | journal=J Am Acad Dermatol | year= 1999 | volume= 40 | issue= 4 | pages= 507-35; quiz 536-8 | pmid=10188670 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10188670  }} </ref><ref name="pmid6801795">{{cite journal| author=Orellana J, Friedman AH| title=Ocular manifestations of multiple myeloma, Waldenström's macroglobulinemia and benign monoclonal gammopathy. | journal=Surv Ophthalmol | year= 1981 | volume= 26 | issue= 3 | pages= 157-69 | pmid=6801795 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6801795  }} </ref><ref name="pmid9686227">{{cite journal| author=Civit T, Coulbois S, Baylac F, Taillandier L, Auque J| title=[Waldenström's macroglobulinemia and cerebral lymphoplasmocytic proliferation: Bing and Neel syndrome. Apropos of a new case]. | journal=Neurochirurgie | year= 1997 | volume= 43 | issue= 4 | pages= 245-9 | pmid=9686227 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9686227  }} </ref><ref name="pmid10357087">{{cite journal| author=Kwaan HC, Bongu A| title=The hyperviscosity syndromes. | journal=Semin Thromb Hemost | year= 1999 | volume= 25 | issue= 2 | pages= 199-208 | pmid=10357087 | doi=10.1055/s-2007-994921 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10357087  }} </ref><ref name="pmid3094151">{{cite journal| author=Farhangi M, Merlini G| title=The clinical implications of monoclonal immunoglobulins. | journal=Semin Oncol | year= 1986 | volume= 13 | issue= 3 | pages= 366-79 | pmid=3094151 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3094151  }} </ref><ref name="pmid2104668">{{cite journal| author=| title=Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 3-1990. A 66-year-old woman with Waldenström's macroglobulinemia, diarrhea, anemia, and persistent gastrointestinal bleeding. | journal=N Engl J Med | year= 1990 | volume= 322 | issue= 3 | pages= 183-92 | pmid=2104668 | doi=10.1056/NEJM199001183220308 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2104668  }} </ref><ref name="GertzKyle1993">{{cite journal|last1=Gertz|first1=M A|last2=Kyle|first2=R A|last3=Noel|first3=P|title=Primary systemic amyloidosis: a rare complication of immunoglobulin M monoclonal gammopathies and Waldenström's macroglobulinemia.|journal=Journal of Clinical Oncology|volume=11|issue=5|year=1993|pages=914–920|issn=0732-183X|doi=10.1200/JCO.1993.11.5.914}}</ref><ref name="pmid12720162">{{cite journal| author=Gertz MA, Kyle RA| title=Amyloidosis with IgM monoclonal gammopathies. | journal=Semin Oncol | year= 2003 | volume= 30 | issue= 2 | pages= 325-8 | pmid=12720162 | doi=10.1053/sonc.2003.50060 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12720162  }} </ref><ref name="pmid11530809">{{cite journal| author=Gardyn J, Schwartz A, Gal R, Lewinski U, Kristt D, Cohen AM| title=Waldenström's macroglobulinemia associated with AA amyloidosis. | journal=Int J Hematol | year= 2001 | volume= 74 | issue= 1 | pages= 76-8 | pmid=11530809 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11530809  }} </ref><ref name="pmid9603799">{{cite journal| author=Ropper AH, Gorson KC| title=Neuropathies associated with paraproteinemia. | journal=N Engl J Med | year= 1998 | volume= 338 | issue= 22 | pages= 1601-7 | pmid=9603799 | doi=10.1056/NEJM199805283382207 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9603799  }} </ref><ref name="pmid11556684">{{cite journal| author=Vital A| title=Paraproteinemic neuropathies. | journal=Brain Pathol | year= 2001 | volume= 11 | issue= 4 | pages= 399-407 | pmid=11556684 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11556684  }} </ref><ref name="pmid6807086">{{cite journal| author=Crisp D, Pruzanski W| title=B-cell neoplasms with homogeneous cold-reacting antibodies (cold agglutinins). | journal=Am J Med | year= 1982 | volume= 72 | issue= 6 | pages= 915-22 | pmid=6807086 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6807086  }} </ref><ref name="pmid6777101">{{cite journal| author=Lindström FD, Hed J, Eneström S| title=Renal pathology of Waldenström's macroglobulinaemia with monoclonal antiglomerular antibodies and nephrotic syndrome. | journal=Clin Exp Immunol | year= 1980 | volume= 41 | issue= 2 | pages= 196-204 | pmid=6777101 | doi= | pmc=1537007 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6777101  }} </ref><ref name="pmid15019332">{{cite journal| author=Sen HN, Chan CC, Caruso RC, Fariss RN, Nussenblatt RB, Buggage RR| title=Waldenström's macroglobulinemia-associated retinopathy. | journal=Ophthalmology | year= 2004 | volume= 111 | issue= 3 | pages= 535-9 | pmid=15019332 | doi=10.1016/j.ophtha.2003.05.036 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15019332  }} </ref>
Following is a list of [[Lymphoplasmacytic lymphoma|LPL]] manifestations with attributable [[causes]]:<ref name="pmid15735132">{{cite journal| author=Dimopoulos MA, Kyle RA, Anagnostopoulos A, Treon SP| title=Diagnosis and management of Waldenstrom's macroglobulinemia. | journal=J Clin Oncol | year= 2005 | volume= 23 | issue= 7 | pages= 1564-77 | pmid=15735132 | doi=10.1200/JCO.2005.03.144 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15735132  }} </ref><ref name="DimopoulosPanayiotidis2000">{{cite journal|last1=Dimopoulos|first1=Meletios A.|last2=Panayiotidis|first2=Panayiotis|last3=Moulopoulos|first3=Lia A.|last4=Sfikakis|first4=Petros|last5=Dalakas|first5=Marinos|title=Waldenström’s Macroglobulinemia: Clinical Features, Complications, and Management|journal=Journal of Clinical Oncology|volume=18|issue=1|year=2000|pages=214–214|issn=0732-183X|doi=10.1200/JCO.2000.18.1.214}}</ref><ref name="pmid3110508">{{cite journal| author=Kyle RA, Garton JP| title=The spectrum of IgM monoclonal gammopathy in 430 cases. | journal=Mayo Clin Proc | year= 1987 | volume= 62 | issue= 8 | pages= 719-31 | pmid=3110508 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3110508  }} </ref><ref name="pmid12883242">{{cite journal| author=Lin P, Bueso-Ramos C, Wilson CS, Mansoor A, Medeiros LJ| title=Waldenstrom macroglobulinemia involving extramedullary sites: morphologic and immunophenotypic findings in 44 patients. | journal=Am J Surg Pathol | year= 2003 | volume= 27 | issue= 8 | pages= 1104-13 | pmid=12883242 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12883242  }} </ref><ref name="pmid8123836">{{cite journal| author=Dimopoulos MA, Alexanian R| title=Waldenstrom's macroglobulinemia. | journal=Blood | year= 1994 | volume= 83 | issue= 6 | pages= 1452-9 | pmid=8123836 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8123836  }} </ref><ref name="pmid6767276">{{cite journal| author=Fudenberg HH, Virella G| title=Multiple myeloma and Waldenström macroglobulinemia: unusual presentations. | journal=Semin Hematol | year= 1980 | volume= 17 | issue= 1 | pages= 63-79 | pmid=6767276 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6767276  }} </ref><ref name="pmid9671845">{{cite journal| author=Fadil A, Taylor DE| title=The lung and Waldenström's macroglobulinemia. | journal=South Med J | year= 1998 | volume= 91 | issue= 7 | pages= 681-5 | pmid=9671845 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9671845  }} </ref><ref name="pmid9198063">{{cite journal| author=Veltman GA, van Veen S, Kluin-Nelemans JC, Bruijn JA, van Es LA| title=Renal disease in Waldenström's macroglobulinaemia. | journal=Nephrol Dial Transplant | year= 1997 | volume= 12 | issue= 6 | pages= 1256-9 | pmid=9198063 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9198063  }} </ref><ref name="pmid10188670">{{cite journal| author=Daoud MS, Lust JA, Kyle RA, Pittelkow MR| title=Monoclonal gammopathies and associated skin disorders. | journal=J Am Acad Dermatol | year= 1999 | volume= 40 | issue= 4 | pages= 507-35; quiz 536-8 | pmid=10188670 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10188670  }} </ref><ref name="pmid6801795">{{cite journal| author=Orellana J, Friedman AH| title=Ocular manifestations of multiple myeloma, Waldenström's macroglobulinemia and benign monoclonal gammopathy. | journal=Surv Ophthalmol | year= 1981 | volume= 26 | issue= 3 | pages= 157-69 | pmid=6801795 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6801795  }} </ref><ref name="pmid9686227">{{cite journal| author=Civit T, Coulbois S, Baylac F, Taillandier L, Auque J| title=[Waldenström's macroglobulinemia and cerebral lymphoplasmocytic proliferation: Bing and Neel syndrome. Apropos of a new case]. | journal=Neurochirurgie | year= 1997 | volume= 43 | issue= 4 | pages= 245-9 | pmid=9686227 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9686227  }} </ref><ref name="pmid10357087">{{cite journal| author=Kwaan HC, Bongu A| title=The hyperviscosity syndromes. | journal=Semin Thromb Hemost | year= 1999 | volume= 25 | issue= 2 | pages= 199-208 | pmid=10357087 | doi=10.1055/s-2007-994921 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10357087  }} </ref><ref name="pmid3094151">{{cite journal| author=Farhangi M, Merlini G| title=The clinical implications of monoclonal immunoglobulins. | journal=Semin Oncol | year= 1986 | volume= 13 | issue= 3 | pages= 366-79 | pmid=3094151 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3094151  }} </ref><ref name="pmid2104668">{{cite journal| author=| title=Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 3-1990. A 66-year-old woman with Waldenström's macroglobulinemia, diarrhea, anemia, and persistent gastrointestinal bleeding. | journal=N Engl J Med | year= 1990 | volume= 322 | issue= 3 | pages= 183-92 | pmid=2104668 | doi=10.1056/NEJM199001183220308 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2104668  }} </ref><ref name="GertzKyle1993">{{cite journal|last1=Gertz|first1=M A|last2=Kyle|first2=R A|last3=Noel|first3=P|title=Primary systemic amyloidosis: a rare complication of immunoglobulin M monoclonal gammopathies and Waldenström's macroglobulinemia.|journal=Journal of Clinical Oncology|volume=11|issue=5|year=1993|pages=914–920|issn=0732-183X|doi=10.1200/JCO.1993.11.5.914}}</ref><ref name="pmid12720162">{{cite journal| author=Gertz MA, Kyle RA| title=Amyloidosis with IgM monoclonal gammopathies. | journal=Semin Oncol | year= 2003 | volume= 30 | issue= 2 | pages= 325-8 | pmid=12720162 | doi=10.1053/sonc.2003.50060 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12720162  }} </ref><ref name="pmid11530809">{{cite journal| author=Gardyn J, Schwartz A, Gal R, Lewinski U, Kristt D, Cohen AM| title=Waldenström's macroglobulinemia associated with AA amyloidosis. | journal=Int J Hematol | year= 2001 | volume= 74 | issue= 1 | pages= 76-8 | pmid=11530809 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11530809  }} </ref><ref name="pmid9603799">{{cite journal| author=Ropper AH, Gorson KC| title=Neuropathies associated with paraproteinemia. | journal=N Engl J Med | year= 1998 | volume= 338 | issue= 22 | pages= 1601-7 | pmid=9603799 | doi=10.1056/NEJM199805283382207 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9603799  }} </ref><ref name="pmid11556684">{{cite journal| author=Vital A| title=Paraproteinemic neuropathies. | journal=Brain Pathol | year= 2001 | volume= 11 | issue= 4 | pages= 399-407 | pmid=11556684 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11556684  }} </ref><ref name="pmid6807086">{{cite journal| author=Crisp D, Pruzanski W| title=B-cell neoplasms with homogeneous cold-reacting antibodies (cold agglutinins). | journal=Am J Med | year= 1982 | volume= 72 | issue= 6 | pages= 915-22 | pmid=6807086 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6807086  }} </ref><ref name="pmid6777101">{{cite journal| author=Lindström FD, Hed J, Eneström S| title=Renal pathology of Waldenström's macroglobulinaemia with monoclonal antiglomerular antibodies and nephrotic syndrome. | journal=Clin Exp Immunol | year= 1980 | volume= 41 | issue= 2 | pages= 196-204 | pmid=6777101 | doi= | pmc=1537007 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6777101  }} </ref><ref name="pmid15019332">{{cite journal| author=Sen HN, Chan CC, Caruso RC, Fariss RN, Nussenblatt RB, Buggage RR| title=Waldenström's macroglobulinemia-associated retinopathy. | journal=Ophthalmology | year= 2004 | volume= 111 | issue= 3 | pages= 535-9 | pmid=15019332 | doi=10.1016/j.ophtha.2003.05.036 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15019332  }} </ref>


{| class="wikitable"
{| class="wikitable"
|+ '''Manifestations of WM'''
|+ '''Manifestations of Lymphoplasmacytic lymphoma'''
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Cause
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Cause
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Manifestations
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Manifestations
|-
|-
| style="background:#DCDCDC;" align="center" + |Tumor infiltration
! style="background:#DCDCDC;" align="center" + |[[Tumor]] [[Infiltration (medical)|infiltration]]
| style="background:#F5F5F5;" align="center" + |Cytopenia, fever, night sweats, weight loss, lymphadenopathy, hepatomegaly, spleenomegaly, pulmonary infiltrates, nodules or masses, pleural effusion, abdominal pain, swelling and blood in stools secondary to stomach and bowel infiltration, renal and perirenal masses, maculopapular lesions, plaques or nodules secondary to dermis infiltration, lesions involving retro-orbital lymphoid tissue and lacrimal glands, infiltration of the conjunctiva and malignant vitreitis, Bing-Neel syndrome consists of confusion, memory loss, disorientation, motor dysfunction, and eventually coma.
| style="background:#F5F5F5;" align="center" + |
* [[Cytopenia]]
* [[Fever]]
* [[Night sweats]]
* [[Weight loss]]
* [[Lymphadenopathy]]
* [[Hepatomegaly]]
* [[Splenomegaly]]
* [[Pulmonary]] [[Infiltration (medical)|infiltrates]]
* [[Nodules]] or [[Mass|masses]]
* [[Pleural effusion]]
* [[Abdominal pain]]
* [[Swelling]]
* [[Blood]] in [[stools]] [[secondary]] to [[stomach]] and [[bowel]] [[Infiltration (medical)|infiltration]]
* [[Renal]] and perirenal [[Mass|masses]]
* [[Maculopapular]] [[lesions]]
* [[Plaques]] or [[nodules]] [[secondary]] to [[dermis]] [[Infiltration (medical)|infiltration]]
*[[Lesions]] involving retro-[[Orbit (anatomy)|orbital]] [[lymphoid tissue]] and [[lacrimal glands]]
*[[Infiltration (medical)|Infiltration]] of the [[conjunctiva]] and [[malignant]] vitreitis
* [[Bing-Neel syndrome]] consists of:
**[[Confusion]]
** [[Memory loss]]
** [[Disorientation]]
** [[Motor control|Motor]] [[dysfunction]]
** [[Coma]]
|-
|-
| style="background:#DCDCDC;" align="center" + |Circulating monoclonal IgM
! style="background:#DCDCDC;" align="center" + |[[Circulatory|Circulating]] [[Monoclonal antibody|monoclonal]] [[IgM]]
| style="background:#F5F5F5;" align="center" + |Hyperviscosity syndrome, Type 1 Cryoglobulinemia (consists of Raynaud's phenomenon, skin ulcers & necrosis and cold urticaria), frequent bruising, prolonged bleeding and clotting times.
| style="background:#F5F5F5;" align="center" + |
* [[Hyperviscosity syndrome]]
* Type 1 [[Cryoglobulinemia]] which consists of:
**[[Raynaud's phenomenon]]
**[[Skin]] [[ulcers]]
**[[Skin]] [[necrosis]]
** [[Cold urticaria]]
* Frequent [[bruising]]
* Prolonged [[bleeding time]]
* Prolonged [[clotting]] time
|-
|-
| style="background:#DCDCDC;" align="center" + |IgM deposition into tissues
! style="background:#DCDCDC;" align="center" + |[[IgM]] [[Deposition (physics)|deposition]] into [[tissues]]
| style="background:#F5F5F5;" align="center" + |Sub-endothelial deposits in glomerular loops leading to non-selective proteinuria, dehydration, and uremia, Firm, flesh-colored skin papules and nodules have been reported and are called macroglobulinemia cutis, Diarrhea, malabsorption, or gastrointestinal bleeding.
| style="background:#F5F5F5;" align="center" + |
* Sub-[[endothelial]] [[Deposition (physics)|deposits]] in [[Glomerular capsule|glomerular loops]] leading to:
**Non-[[Selection|selective]] [[proteinuria]]
**[[Dehydration]]
**[[Uremia]]
* Firm, [[flesh]]-[[Color|colored]] [[skin]] [[papules]] and [[nodules]], called [[macroglobulinemia]] [[cutis]]
* [[Diarrhea]]
* [[Malabsorption]]
* [[Gastrointestinal bleeding]]
|-
|-
| style="background:#DCDCDC;" align="center" + |Amyloidogenic properties of IgM
! style="background:#DCDCDC;" align="center" + |[[Amyloidogenic]] properties of [[IgM]]
| style="background:#F5F5F5;" align="center" + |Organs more commonly affected by amyloidosis were the heart (44%), the peripheral nerves (38%), the kidneys (32%), the soft tissues (18%), the liver (14%), and lungs (10%), nephrotic syndrome and gastrointestinal involvement.
| style="background:#F5F5F5;" align="center" + |
* [[Organs]] more commonly [[Affect|affected]] by [[amyloidosis]] are:
**[[Heart]] (44%):
***Unexplained [[cardiac failure]]
**[[Peripheral nerves]] (38%)
**[[Kidneys]] (32%):
***[[Nephrotic syndrome]]
**[[Soft tissue|Soft tissues]] (18%):
**[[Liver]] (14%)
**[[Lungs]] (10%)
**[[Gastrointestinal]] involvement:
***[[Intestinal]] dysmotility
**[[Skin]]:
***[[Purpura]]
**[[Tongue]]:
***[[Macroglossia]]
|-
|-
| style="background:#DCDCDC;" align="center" + |Autoantibody activity of IgM
! style="background:#DCDCDC;" align="center" + |[[Autoantibody]] [[Activity (chemistry)|activity]] of [[IgM]]
| style="background:#F5F5F5;" align="center" + |Distal, symmetric, chronic demyelinating peripheral neuropathy, Type 2 cryoglobulinemia characterized by vasculitis affecting small vessels of skin, kidneys, liver, and peripheral nerves, Extravascular chronic hemolytic anemia called cold agglutinin disease exacerbated by cold exposure, glomerulonephritis, paraneoplastic pemphigus, and retinitis/retinopathy.
| style="background:#F5F5F5;" align="center" + |
* [[Distal]], [[Symmetric function|symmetric]], [[Chronic (medical)|chronic]] [[myelin]]-[[Association (statistics)|associated]] [[glycoprotein]] [[antibody]]-positive [[demyelinating]] [[peripheral neuropathy]]
* Type 2 [[cryoglobulinemia]] characterized by [[vasculitis]] [[Affect|affecting]] small [[vessels]] of:
**[[Skin]]
**[[Kidneys]]
**[[Liver]]
**[[Peripheral nerves]]
* Extravascular [[chronic hemolytic anemia]] called [[cold agglutinin disease]] exacerbated by [[cold exposure]]
* [[Glomerulonephritis]]
* [[Paraneoplastic]] [[pemphigus]]
* [[Retinitis]]/[[retinopathy]]
|}
|}
==== Common Symptoms ====
==== Common Symptoms ====
Common symptoms of Waldenström macroglobulinemia include:<ref name="pmid11736938">{{cite journal| author=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A et al.| title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. | journal=Br J Haematol | year= 2001 | volume= 115 | issue= 3 | pages= 575-82 | pmid=11736938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11736938  }} </ref><ref name="pmid12720138">{{cite journal| author=Merlini G, Baldini L, Broglia C, Comelli M, Goldaniga M, Palladini G et al.| title=Prognostic factors in symptomatic Waldenstrom's macroglobulinemia. | journal=Semin Oncol | year= 2003 | volume= 30 | issue= 2 | pages= 211-5 | pmid=12720138 | doi=10.1053/sonc.2003.50064 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12720138  }} </ref>
Common [[symptoms]] of [[lymphoplasmacytic lymphoma]] include:<ref name="pmid11736938">{{cite journal| author=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A et al.| title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. | journal=Br J Haematol | year= 2001 | volume= 115 | issue= 3 | pages= 575-82 | pmid=11736938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11736938  }} </ref><ref name="pmid12720138">{{cite journal| author=Merlini G, Baldini L, Broglia C, Comelli M, Goldaniga M, Palladini G et al.| title=Prognostic factors in symptomatic Waldenstrom's macroglobulinemia. | journal=Semin Oncol | year= 2003 | volume= 30 | issue= 2 | pages= 211-5 | pmid=12720138 | doi=10.1053/sonc.2003.50064 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12720138  }} </ref>
* [[B symptoms|Constitutional B symptoms]] as seen in other types of NHL:
* [[B symptoms|Constitutional B symptoms]] as seen in other types of [[NHL]]:
**[[Weakness]] (due to normocytic anemia associated with IgM binding to RBCs).
**[[Weakness]] (due to [[normocytic anemia]] [[Association (statistics)|associated]] with [[IgM]] [[Binding (molecular)|binding]] to [[RBCs]])
**[[Anorexia]].
**[[Anorexia]]
**Unexplained [[weight loss]].
**Unexplained [[weight loss]]
**Unexplained [[fever]].
**Unexplained [[fever]]
**Heavy sweating, especially at night causing drenching of one's cloths and bedsheet.
**Heavy [[sweating]], especially at [[Night Sweats|night]] [[Causes|causing]] drenching of one's cloths and bedsheet
**Severe/extensive skin itchiness.
**Severe/extensive [[skin]] [[itchiness]]
*Fatigue.
*[[Fatigue]]
*Sensorimotor [[peripheral neuropathy]] (mostly associated with numbness and tingling, i.e. painful pins and needle sensation, of the fingers or toes).
*[[Sensorimotor]] [[peripheral neuropathy]] (mostly [[Association (statistics)|associated]] with [[numbness]] and [[tingling]], i.e. [[painful]] pins and needle [[Sensation|sensation,]] of the [[fingers]] or [[toes]])
*[[Blurred vision|Blurry vision]] or blind spots.
*[[Blurred vision|Blurry vision]] or [[Blind spot (vision)|blind spots]]
*Abdominal pain.
*[[Abdominal pain]]


==== Less Common Symptoms ====
==== Less Common Symptoms ====
Less common symptoms of Waldenström macroglobulinemia include:<ref name="pmid11736938">{{cite journal| author=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A et al.| title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. | journal=Br J Haematol | year= 2001 | volume= 115 | issue= 3 | pages= 575-82 | pmid=11736938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11736938  }} </ref><ref name="pmid12720138">{{cite journal| author=Merlini G, Baldini L, Broglia C, Comelli M, Goldaniga M, Palladini G et al.| title=Prognostic factors in symptomatic Waldenstrom's macroglobulinemia. | journal=Semin Oncol | year= 2003 | volume= 30 | issue= 2 | pages= 211-5 | pmid=12720138 | doi=10.1053/sonc.2003.50064 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12720138  }} </ref>
Less common [[symptoms]] of [[lymphoplasmacytic lymphoma]] include:<ref name="pmid11736938">{{cite journal| author=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A et al.| title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. | journal=Br J Haematol | year= 2001 | volume= 115 | issue= 3 | pages= 575-82 | pmid=11736938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11736938  }} </ref><ref name="pmid12720138">{{cite journal| author=Merlini G, Baldini L, Broglia C, Comelli M, Goldaniga M, Palladini G et al.| title=Prognostic factors in symptomatic Waldenstrom's macroglobulinemia. | journal=Semin Oncol | year= 2003 | volume= 30 | issue= 2 | pages= 211-5 | pmid=12720138 | doi=10.1053/sonc.2003.50064 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12720138  }} </ref>
*Enlarged lymph nodes (appearing as 1-2 inches sized lumps under the skin in neck, groin or the armpits).
*[[Enlarged lymph nodes]] ([[Appearance|appearing]] as 1-2 inches sized [[Lump|lumps]] under the [[skin]] in [[neck]], [[groin]] or the [[armpits]]).
*Swollen belly/abdomen (due to hepatosplenomegaly).
*[[Swollen belly]]/[[abdomen]] (due to [[hepatosplenomegaly]]).
*Pain or a feeling of fullness below the ribs on the left side.
*[[Pain]] or a [[feeling]] of fullness below the [[ribs]] on the left side.
*Painless lumps in the neck, underarm, stomach, or groin
*Painless [[Lump|lumps]] in the [[neck]], [[underarm]], [[stomach]], or [[groin]].
*Headache.
*[[Headache]].
*Raised pink/flesh-colored lesions on skin.
*Raised [[Pinks|pink]]/[[flesh]]-[[Color|colored]] [[lesions]] on [[skin]].
*Altered mental status due to decreased blood flow and infiltration of CNS leading to:
*[[Altered mental status]] due to decreased [[blood flow]] and [[Infiltration (medical)|infiltration]] of [[CNS]] leading to:
**[[Bing–Neel syndrome|Bing-Neel syndrome]] which includes:
**[[Bing-Neel syndrome]] which includes:
***[[Confusion]].
***[[Confusion]]
***Dizziness.
***[[Dizziness]]
***[[Memory loss]].
***[[Memory loss]]
***[[Motor disorders]].
***[[Motor disorders]]
*Symptoms resembling stroke like slurred speech or weakness on one side of body (such patients are advised to consult from their doctor right away).
*[[Symptoms]] resembling [[stroke]] like [[slurred speech]] or [[weakness]] on one side of [[body]] (such [[patients]] are advised to [[Consultation|consult]] from their [[Doctor of Medicine|doctor]] right away).
*Abnormal mucous membrane bleeding (epistaxis, bleeding gums).
*[[Abnormal]] [[mucous membrane]] [[bleeding]] ([[epistaxis]], [[bleeding gums]]).
*Vision problems (blurred vision, double vision or blind spots).
*[[Vision problems]] ([[blurred vision]], [[double vision]] or [[Blind spot|blind spots]]).
*Kidney problems (leading to weakness, trouble breathing and fluid buildup in body tissues associated with accumulation of excess salt, fluid and waste products in blood secondary to amyloidosis).  
*[[Kidney]] problems (leading to [[weakness]], trouble [[breathing]] and [[fluid]] buildup in [[body]] [[tissues]] [[Association (statistics)|associated]] with accumulation of excess [[salt]], [[fluid]] and waste [[Product (chemistry)|products]] in [[blood]] [[secondary]] to [[amyloidosis]]).
*Heart problems (Secondary to amyloidosis, build up of M protein in heart affects its pumping ability, and also the heart has to work harder to pump the thick blood ultimately leading to CHF with following symptoms).
*[[Heart]] problems ([[Secondary]] to [[amyloidosis]], build up of [[M protein]] in [[heart]] [[Affect|affects]] its [[Pump|pumping]] ability, and also the [[heart]] has to work harder to [[pump]] the thick [[blood]] ultimately leading to [[CHF]] with following [[symptoms]]):
**Palpitations.
**[[Palpitations]]
**Feeling of tiredness and weakness.
**[[Feeling]] of [[tiredness]] and [[weakness]]
**Cough.
**[[Cough]]
**Shortness of breath.
**[[Shortness of breath]]
**Rapid weight gain.
**Rapid [[weight gain]]
**Swelling of feet and legs.
**[[Swelling]] of [[feet]] and [[legs]]
*Infections (high levels of abnormal antibody in WM slows down the production of normal antibodies).
*[[Infections]] (high levels of [[abnormal]] [[antibody]] in WM slows down the [[Product (biology)|production]] of [[normal]] [[antibodies]])
*Digestive problems due to deposition of IgM protein in the [[lamina propria]] of the [[intestinal wall]] include:
*[[Digestive]] problems due to [[Deposition (physics)|deposition]] of [[IgM]] [[protein]] in the [[lamina propria]] of the [[intestinal wall]] include:
**Diarrhea.
**[[Diarrhea]]
**Poor absorption of vitamins.
**Poor [[absorption]] of [[vitamins]]
**GIT bleeding/[[steatorrhea]] (blood in stools/dark stools).
**[[Gastrointestinal bleeding|GIT bleeding]]/[[steatorrhea]] ([[Blood in stool|blood in stools]]/[[Stools are black and tarry|dark stools]])
*Sensitivity to cold ([[Raynaud's phenomenon]] due to [[cryoglobulinemia]] in 5% WM patients), which is associated with reduced blood flow leading to pain, itching, bluish discoloration or sores in following body parts:
*[[Sensitivity]] to [[cold]] ([[Raynaud's phenomenon]] due to [[cryoglobulinemia]] in 5% WM [[patients]]), which is [[Association (statistics)|associated]] with reduced [[blood flow]] leading to [[pain]], [[itching]], [[Bluish discoloration of the skin|bluish discoloration]] or [[Sore|sores]] in following [[Human body|body]] parts:
**Tip of nose.
**Tip of [[nose]]
**Ears.
**[[Ears]]
**Fingers.
**[[Fingers]]
**Toes.
**[[Toes]]
*Cryoglobulinemia also leads to:
*[[Clinical]] manifestations of '''[[cryoglobulinemia]]''' include:
**Numbness and tingling in hands and feet.
**[[Numbness]] and [[tingling]] in [[hands]] and [[feet]]
**Joint aches.
**[[Joint aches]]
**Small bruises.
**Small [[bruises]]
**Skin ulcers.
**[[Skin]] [[ulcers]]
**[[Purpura]]
**Digital [[ischemia]]
**[[Arthralgia]]
**[[Fever]]
**[[Raynaud phenomenon]]
*[[Clinical]] manifestations of '''[[Cold agglutinin disease]]''' include:
**[[Livedo reticularis]]
**[[Acrocyanosis]]
**[[Raynaud's phenomenon|Raynaud phenomenon]]


==== Symptoms Secondary to Hyperviscosity Syndrome ====
==== Symptoms Secondary to Hyperviscosity Syndrome ====
The lymphoma cells make varying amounts of a monoclonal protein called immunoglobulin M (IgM, or macroglobulin). Higher amounts of this protein than normal in blood tends to make it thick leading to [[hyperviscosity syndrome]] which occurs in approximately 15-20% patients of WM. When blood becomes thick, it is harder for blood to flow through small blood vessels, and when this occurs, the condition is termed as Waldenstrom macroglobulinemia. This excess amount of IgM antibodies can be ultimately associated with circulatory problems leading to less blood flow to the brain, the eyes or other organs.Clinical manifestations of hyperviscosity syndrome occur only if serum [[viscosity]] is >4 centipoises and include:<ref name="pmid11736938">{{cite journal| author=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A et al.| title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. | journal=Br J Haematol | year= 2001 | volume= 115 | issue= 3 | pages= 575-82 | pmid=11736938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11736938  }} </ref>
The [[lymphoma]] [[Cells (biology)|cells]] make varying [[Amount of substance|amounts]] of a [[Monoclonal antibodies|monoclonal]] [[protein]] called [[immunoglobulin M]] ([[IgM]], or [[macroglobulin]]). Higher [[Amount of substance|amounts]] of this [[protein]] than normal in [[blood]] tends to make it thick leading to [[hyperviscosity syndrome]] which occurs in approximately 15-20% [[patients]] of WM. When [[blood]] becomes thick, it is harder for [[blood]] to [[flow]] through small [[blood vessels]], and when this occurs, the [[condition]] is termed as [[Waldenström's macroglobulinemia|Waldenstrom macroglobulinemia]]. This [[Excess risk|excess]] [[Amount of substance|amount]] of [[IgM]] [[antibodies]] can be ultimately [[Association (statistics)|associated]] with [[circulatory]] problems leading to less [[blood flow]] to the [[brain]], [[eyes]] or other [[organs]]. [[Clinical]] manifestations of [[hyperviscosity syndrome]] occur only if [[serum]] [[viscosity]] is >4 centipoises and include:<ref name="pmid11736938">{{cite journal| author=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A et al.| title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. | journal=Br J Haematol | year= 2001 | volume= 115 | issue= 3 | pages= 575-82 | pmid=11736938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11736938  }} </ref>
*Symptoms resembling those of [[stroke]].
*[[Symptoms]] resembling those of [[stroke]]
* Retinal [[hemorrhage]] with [[Blurred vision|blurring of vision]]/loss of vision.
* [[Retinal]] [[hemorrhage]] with [[Blurred vision|blurring of vision]]/[[loss of vision]]
*[[Vertigo]].
*[[Dizziness]]
*[[Dizziness]].
*[[Headache]]
*[[Headache]].
*[[Loss of coordination]]
*[[Loss of coordination]].
*[[Nystagmus]]
*[[Nystagmus]].
*[[Tinnitus]]
*[[Tinnitus]].
*[[Bleeding]]
*[[Ataxia]].
*[[Shortness of breath]]
* [[Bleeding]].
*[[Numbness]] and [[tingling]] of the [[fingers]] or [[toes]] (called [[peripheral neuropathy]])
*Shortness of breath.
*[[Muscle weakness]]
*Numbness and tingling of the fingers or toes (called peripheral neuropathy).
*[[Confusion]]
*Muscle weakness.
*Not all people with LPL develop [[hyperviscosity]], [[cryoglobulins]], or [[amyloidosis]]
*Confusion.
*Not all people with WM develop hyperviscosity, cryoglobulins, or amyloidosis.


==References==
==References==
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[[Category:Hematology]]

Latest revision as of 14:30, 15 August 2019

Lymphoplasmacytic lymphoma Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2]

Overview

Many patients with lymphoplasmacytic lymphoma are asymptomatic. The disease is subtle and symptoms are nonspecific and are caused by tumor infiltration, circulating monoclonal IgM, IgM deposition into tissues, amyloidogenic properties of IgM, and autoantibody activity of IgM. The most common symptoms of lymphoplasmacytic lymphoma include weakness, anorexia, unexplained weight loss, fever, heavy sweating, blurry vision, peripheral neuropathy, and abdominal pain. Less common symptoms of the disease include enlarged lymph nodes, abdominal distension, headache, painless lumps, raynaud phenomenon, altered mental status, mucosal bleeding, vision problems, kidney issues, heart problems, infections, GIT problems, and other symptoms due to cryoglobulinemia, cold agglutinin disease, hyperviscosity syndrome, and bing-neel syndrome.

History and Symptoms

History

Manifestations of Lymphoplasmacytic lymphoma

Following is a list of LPL manifestations with attributable causes:[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]

Manifestations of Lymphoplasmacytic lymphoma
Cause Manifestations
Tumor infiltration
Circulating monoclonal IgM
IgM deposition into tissues
Amyloidogenic properties of IgM
Autoantibody activity of IgM

Common Symptoms

Common symptoms of lymphoplasmacytic lymphoma include:[1][25]

Less Common Symptoms

Less common symptoms of lymphoplasmacytic lymphoma include:[1][25]

Symptoms Secondary to Hyperviscosity Syndrome

The lymphoma cells make varying amounts of a monoclonal protein called immunoglobulin M (IgM, or macroglobulin). Higher amounts of this protein than normal in blood tends to make it thick leading to hyperviscosity syndrome which occurs in approximately 15-20% patients of WM. When blood becomes thick, it is harder for blood to flow through small blood vessels, and when this occurs, the condition is termed as Waldenstrom macroglobulinemia. This excess amount of IgM antibodies can be ultimately associated with circulatory problems leading to less blood flow to the brain, eyes or other organs. Clinical manifestations of hyperviscosity syndrome occur only if serum viscosity is >4 centipoises and include:[1]

References

  1. ↑ 1.0 1.1 1.2 1.3 García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A; et al. (2001). "Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases". Br J Haematol. 115 (3): 575–82. PMID 11736938.
  2. ↑ Dimopoulos MA, Panayiotidis P, Moulopoulos LA, Sfikakis P, Dalakas M (2000). "Waldenström's macroglobulinemia: clinical features, complications, and management". J Clin Oncol. 18 (1): 214–26. doi:10.1200/JCO.2000.18.1.214. PMID 10623712.
  3. ↑ Dimopoulos MA, Kyle RA, Anagnostopoulos A, Treon SP (2005). "Diagnosis and management of Waldenstrom's macroglobulinemia". J Clin Oncol. 23 (7): 1564–77. doi:10.1200/JCO.2005.03.144. PMID 15735132.
  4. ↑ Dimopoulos, Meletios A.; Panayiotidis, Panayiotis; Moulopoulos, Lia A.; Sfikakis, Petros; Dalakas, Marinos (2000). "Waldenström's Macroglobulinemia: Clinical Features, Complications, and Management". Journal of Clinical Oncology. 18 (1): 214–214. doi:10.1200/JCO.2000.18.1.214. ISSN 0732-183X.
  5. ↑ Kyle RA, Garton JP (1987). "The spectrum of IgM monoclonal gammopathy in 430 cases". Mayo Clin Proc. 62 (8): 719–31. PMID 3110508.
  6. ↑ Lin P, Bueso-Ramos C, Wilson CS, Mansoor A, Medeiros LJ (2003). "Waldenstrom macroglobulinemia involving extramedullary sites: morphologic and immunophenotypic findings in 44 patients". Am J Surg Pathol. 27 (8): 1104–13. PMID 12883242.
  7. ↑ Dimopoulos MA, Alexanian R (1994). "Waldenstrom's macroglobulinemia". Blood. 83 (6): 1452–9. PMID 8123836.
  8. ↑ Fudenberg HH, Virella G (1980). "Multiple myeloma and Waldenström macroglobulinemia: unusual presentations". Semin Hematol. 17 (1): 63–79. PMID 6767276.
  9. ↑ Fadil A, Taylor DE (1998). "The lung and Waldenström's macroglobulinemia". South Med J. 91 (7): 681–5. PMID 9671845.
  10. ↑ Veltman GA, van Veen S, Kluin-Nelemans JC, Bruijn JA, van Es LA (1997). "Renal disease in Waldenström's macroglobulinaemia". Nephrol Dial Transplant. 12 (6): 1256–9. PMID 9198063.
  11. ↑ Daoud MS, Lust JA, Kyle RA, Pittelkow MR (1999). "Monoclonal gammopathies and associated skin disorders". J Am Acad Dermatol. 40 (4): 507–35, quiz 536-8. PMID 10188670.
  12. ↑ Orellana J, Friedman AH (1981). "Ocular manifestations of multiple myeloma, Waldenström's macroglobulinemia and benign monoclonal gammopathy". Surv Ophthalmol. 26 (3): 157–69. PMID 6801795.
  13. ↑ Civit T, Coulbois S, Baylac F, Taillandier L, Auque J (1997). "[Waldenström's macroglobulinemia and cerebral lymphoplasmocytic proliferation: Bing and Neel syndrome. Apropos of a new case]". Neurochirurgie. 43 (4): 245–9. PMID 9686227.
  14. ↑ Kwaan HC, Bongu A (1999). "The hyperviscosity syndromes". Semin Thromb Hemost. 25 (2): 199–208. doi:10.1055/s-2007-994921. PMID 10357087.
  15. ↑ Farhangi M, Merlini G (1986). "The clinical implications of monoclonal immunoglobulins". Semin Oncol. 13 (3): 366–79. PMID 3094151.
  16. ↑ "Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 3-1990. A 66-year-old woman with Waldenström's macroglobulinemia, diarrhea, anemia, and persistent gastrointestinal bleeding". N Engl J Med. 322 (3): 183–92. 1990. doi:10.1056/NEJM199001183220308. PMID 2104668.
  17. ↑ Gertz, M A; Kyle, R A; Noel, P (1993). "Primary systemic amyloidosis: a rare complication of immunoglobulin M monoclonal gammopathies and Waldenström's macroglobulinemia". Journal of Clinical Oncology. 11 (5): 914–920. doi:10.1200/JCO.1993.11.5.914. ISSN 0732-183X.
  18. ↑ Gertz MA, Kyle RA (2003). "Amyloidosis with IgM monoclonal gammopathies". Semin Oncol. 30 (2): 325–8. doi:10.1053/sonc.2003.50060. PMID 12720162.
  19. ↑ Gardyn J, Schwartz A, Gal R, Lewinski U, Kristt D, Cohen AM (2001). "Waldenström's macroglobulinemia associated with AA amyloidosis". Int J Hematol. 74 (1): 76–8. PMID 11530809.
  20. ↑ Ropper AH, Gorson KC (1998). "Neuropathies associated with paraproteinemia". N Engl J Med. 338 (22): 1601–7. doi:10.1056/NEJM199805283382207. PMID 9603799.
  21. ↑ Vital A (2001). "Paraproteinemic neuropathies". Brain Pathol. 11 (4): 399–407. PMID 11556684.
  22. ↑ Crisp D, Pruzanski W (1982). "B-cell neoplasms with homogeneous cold-reacting antibodies (cold agglutinins)". Am J Med. 72 (6): 915–22. PMID 6807086.
  23. ↑ Lindström FD, Hed J, Eneström S (1980). "Renal pathology of Waldenström's macroglobulinaemia with monoclonal antiglomerular antibodies and nephrotic syndrome". Clin Exp Immunol. 41 (2): 196–204. PMC 1537007. PMID 6777101.
  24. ↑ Sen HN, Chan CC, Caruso RC, Fariss RN, Nussenblatt RB, Buggage RR (2004). "Waldenström's macroglobulinemia-associated retinopathy". Ophthalmology. 111 (3): 535–9. doi:10.1016/j.ophtha.2003.05.036. PMID 15019332.
  25. ↑ 25.0 25.1 Merlini G, Baldini L, Broglia C, Comelli M, Goldaniga M, Palladini G; et al. (2003). "Prognostic factors in symptomatic Waldenstrom's macroglobulinemia". Semin Oncol. 30 (2): 211–5. doi:10.1053/sonc.2003.50064. PMID 12720138.

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