Waldenström's macroglobulinemia other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mirdula Sharma, MBBS [2]

Overview

Patients with waldenström's macroglobulinemia should have nerve conduction study, antimyelin associated glycoprotein serology^[1], and fundoscopy done.^[2] Bone marrow aspirate is frequently hypocellular in waldenström's macroglobulinemia. Biopsy specimen is usually hypercellular and infiltrated with lymphoid and plasmacytoid cells. Dutcher bodies (PAS positive Intranuclear vacuoles containing IgM monoclonal protein) are characteristic feature of waldenström's macroglobulinemia.^[3]

Findings in Nerve Conduction Study

Patients with waldenström's macroglobulinemia show demyelination with sensory involvement more than motor.^[1]

Findings in Serology

Waldenström's macroglobulinemia shows antimyelin associated glycoprotein.^[1]

Findings in Fundoscopy

Waldenström's macroglobulinemia may show enlarged veins in the retina.^[2]

Findings in Bone Marrow Aspirate

Bone marrow aspirate is frequently hypocellular.^[3]

Findings in Bone Marrow Biopsy

Biopsy specimen is usually hypercellular and infiltrated with lymphoid and plasmacytoid cells.
Dutcher bodies (PAS positive Intranuclear vacuoles containing IgM monoclonal protein) are the characteristic features of waldenström's 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)

References

↑ ^1.0 ^1.1 ^1.2 Nobile-Orazio E, Marmiroli P, Baldini L, Spagnol G, Barbieri S, Moggio M, Polli N, Polli E, Scarlato G (1987). "Peripheral neuropathy in macroglobulinemia: incidence and antigen-specificity of M proteins". Neurology. 37 (9): 1506–14. PMID 2442666.
↑ ^2.0 ^2.1 Waldenström's macroglobulinemia. MedlinePlus (2015)https://www.nlm.nih.gov/medlineplus/ency/article/000588.htm Accessed on November 16, 2015
↑ ^3.0 ^3.1 Agarwal A, Ghobrial IM (2013). "The bone marrow microenvironment in Waldenström macroglobulinemia". Clin Lymphoma Myeloma Leuk. 13 (2): 218–21. doi:10.1016/j.clml.2013.02.006. PMC 3654400. PMID 23490994.

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[ser-1] 1.0 ^1.1 ^1.2 Nobile-Orazio E, Marmiroli P, Baldini L, Spagnol G, Barbieri S, Moggio M, Polli N, Polli E, Scarlato G (1987). "Peripheral neuropathy in macroglobulinemia: incidence and antigen-specificity of M proteins". Neurology. 37 (9): 1506–14. PMID 2442666.

[eye-2] 2.0 ^2.1 Waldenström's macroglobulinemia. MedlinePlus (2015)https://www.nlm.nih.gov/medlineplus/ency/article/000588.htm Accessed on November 16, 2015

[BME-3] 3.0 ^3.1 Agarwal A, Ghobrial IM (2013). "The bone marrow microenvironment in Waldenström macroglobulinemia". Clin Lymphoma Myeloma Leuk. 13 (2): 218–21. doi:10.1016/j.clml.2013.02.006. PMC 3654400. PMID 23490994.

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