Korean J Hematol.  1999 Nov;34(4):630-635.

A Case of Pleural Involvement in Patient with Waldenstr m's Macroglobulinemia

• Jang JH
• Hahn JS
• Han SH
• Ko WK
• Lee ST
• Min YH
• Ko YW
• Kim SK

Abstract

Waldenstr m's macroglobulinemia (WM) is a rare lymphoproliferative disorder characterized by lymphocytic tumor infiltration of the bone marrow and monoclonal IgM gammopathy. There had been anecdotal reports of pleural involvement in WM. We experienced a case of WM with pleural involvement and reported here for the first time in Korea with review of literature. A 73-year-old male patient was admitted to our hospital due to dizziness and general weakness. Serum protein electrophoresis showed M-peak in the gamma-globulin region, which was revealed as IgM kappa macroglobulin by serum and urine immunoelectrophoresis. He complained headache, visual disturbance and epistaxis associated with hyperviscosity syndrome and plasma filtration and combination chemotherapy was performed immediately. Symptoms and laboratory parameters such as serum IgM level and globulin fraction were markedly improved thereafter. But during the treatment, insidiously progressive exertional dyspnea was developed and the chest X-ray showed bilateral pleural effusion. The pleural fluid contained abundant plasmacytoid lymphocytes with reactive mesothelial cells. His dyspnea was completely resolved with clearing of the radiographic pleural effusion after continued steroid therapy.

Keyword

Waldenstr m's macroglobulinemia; Pleural involvement

MeSH Terms

Aged
Bone Marrow
Dizziness
Drug Therapy, Combination
Dyspnea
Electrophoresis
Epistaxis
Filtration
gamma-Globulins
Headache
Humans
Immunoelectrophoresis
Immunoglobulin M
Korea
Lymphocytes
Lymphoproliferative Disorders
Male
Plasma
Pleural Effusion
Thorax
Waldenstrom Macroglobulinemia*
Immunoglobulin M
gamma-Globulins