Abstract

The Waldenstrom's macroglobulinemia is a slow growing progressive malignant lymphoproliferative disorder and characterized by macroglobulin(Ig M) paraprotein "spike" on the serum protein electrophoresis associated with bone marrow proliferation of plasmacytoid lymphocyte. The age at diagnosis of patient of ranging from 4th to 9th decade and the peak age is 6th to 7th decade. The major criteria for diagnosis are a monoclonal IgM serum protein abnormality present in concentrations greater than 1g/㎗ and clinical manifestations included weight loss, bleeding tendency, presence of abnormal masses, lymphadenopathy, hepatosplenomegaly, central and peripheral neuropathy and hyperviscosity syndrome may develop as a complication of macroglobulinemia. We experienced one case of Waldenstrom's macroglobulinemia, 68-year-old woman, who visited our hospital due to slow growing multiple cervical masses. On physical examination, painless cervical, axillary and inguinal lymphadenopathy, and hepatomegaly were noted. The hematological study showed moderate degree of normocytic normochromic anemia. The serum protein electrophoresis showed typical monoclonal gammopathy. The serum protein immunoelectrophoresis revealed IgM-lambda type M-protein. Concentration of IgM was 3.04 g/㎗. Bone marrow aspiration findings were nonspecific except slightly increase of plasma cells. The findings of bone marrow and lymph node biopsies showed no evidence of malignancy as lymphoma or leukemia. The peroxidase antiperoxidase (PAP) and methyl green pyronine stains of bone marrow and lymph node also showed non-specific findings. The B-lymphocyte count of the peripheral blood by immunoflurorescent method revealed markedly increased subsets along with the increased total B-cell counts.