Waldenström's macroglobulinemia other diagnostic studies: Difference between revisions
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==Overview== | ==Overview== | ||
Patients with waldenström's macroglobulinemia should have nerve conduction study, [[antimyelin associated glycoprotein]] serology<ref name="ser" | Patients with waldenström's macroglobulinemia should have nerve conduction study, [[antimyelin associated glycoprotein]] serology<ref name="ser" />, and fundoscopy done.<ref name="eye">Waldenström's macroglobulinemia. MedlinePlus (2015)https://www.nlm.nih.gov/medlineplus/ency/article/000588.htm Accessed on November 16, 2015</ref> 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.<ref name="BME">{{cite journal |vauthors=Agarwal A, Ghobrial IM |title=The bone marrow microenvironment in Waldenström macroglobulinemia |journal=Clin Lymphoma Myeloma Leuk |volume=13 |issue=2 |pages=218–21 |year=2013 |pmid=23490994 |pmc=3654400 |doi=10.1016/j.clml.2013.02.006 |url=}}</ref> | ||
==Findings in Nerve Conduction Study== | ==Findings in Nerve Conduction Study== | ||
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:*Lymphoplasmacytic cells (small lymphocytes, mature plasma cells, mast cells) in an interstitial/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) | :*A polymorphous infiltrate (small lymphocytes, plasma cells, plasmacytoid cells, immunoblasts with mitotic figures) | ||
:* '''Plasma viscosity''' | |||
:** Plasma viscosity should be measured in patients presenting with [[hyperviscosity syndrome]] whenever the monoclonal IgM protein spike is >4 g/dL. | |||
:** The normal plasma viscosity is 1.8 centipoise. | |||
:** Patient presents with hyperviscosity symptoms with viscosity >4 centipoise. | |||
==References== | ==References== |
Revision as of 02:12, 31 October 2018
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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
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)
- Plasma viscosity
- Plasma viscosity should be measured in patients presenting with hyperviscosity syndrome whenever the monoclonal IgM protein spike is >4 g/dL.
- The normal plasma viscosity is 1.8 centipoise.
- Patient presents with hyperviscosity symptoms with viscosity >4 centipoise.
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.