Waldenström's macroglobulinemia other diagnostic studies: Difference between revisions

Jump to navigation Jump to search
No edit summary
Line 4: Line 4:


==Overview==
==Overview==
Patients with waldenström's macroglobulinemia should have nerve conduction study, [[antimyelin associated glycoprotein]] serology<ref name="ser"></ref>, 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>
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==
Line 25: Line 25:
:*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

Waldenström's macroglobulinemia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Waldenström's macroglobulinemia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Bone Marrow Aspiration and Biopsy

Electrophoresis and Immunofixation

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Waldenström's macroglobulinemia other diagnostic studies On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Waldenström's macroglobulinemia other diagnostic studies

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Waldenström's macroglobulinemia other diagnostic studies

CDC on Waldenström's macroglobulinemia other diagnostic studies

Waldenström's macroglobulinemia other diagnostic studies in the news

Blogs on Waldenström's macroglobulinemia other diagnostic studies

Directions to Hospitals Treating Waldenström's macroglobulinemia

Risk calculators and risk factors for Waldenström's macroglobulinemia other diagnostic studies

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

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)
  • 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. 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. 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. 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.

Template:WH Template:WS