Waldenström's macroglobulinemia bone marrow aspiration and biopsy

Waldenström's macroglobulinemia Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Roukoz A. Karam, M.D.[2]

Overview

A bone marrow aspiration may be helpful in the diagnosis of Waldenström macroglobulinemia. A bone marrow biopsy can be diagnostic of Waldenström macroglobulinemia.

Bone Marrow Aspirate

A bone marrow aspirate may be helpful in the diagnosis of Waldenström macroglobulinemia.

Findings suggestive of Waldenström macroglobulinemia include:

• A hypocellular bone marrow aspirate

Bone Marrow Biopsy

A bone marrow biopsy may be helpful in the diagnosis of Waldenström macroglobulinemia.

Findings on the biopsy suggestive of Waldenström macroglobulinemia include:

• Hypercellular and infiltrated with lymphoid and plasmacytoid cells.

• Dutcher bodies (PAS positive Intranuclear vacuoles containing IgM monoclonal protein)
  • Characteristic feature of Waldenström macroglobulinemia.

Three patterns of marrow involvement are described, as follows:

• Lymphoplasmacytoid cells (lymphoplasmacytic and small lymphocytes) in a nodular pattern
• Lymphoplasmacytic cells (small lymphocytes, mature plasma cells, mast cells) in an interstitial/nodular pattern
• A polymorphous infiltrate (small lymphocytes, plasma cells, plasmacytoid cells, immunoblasts with mitotic figures)