Τίτλος:
Differential diagnosis of Waldenstrom's macroglobulinemia and other
B-cell disorders
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Waldenstrom’s macroglobulinemia (WM) is characterized by
lymphoplasmacytic infiltration of bone marrow and/or other tissues and
by the presence of serum monoclonal immunoglobulin M ([IgM], without
cutoff limit), Differential diagnosis from other B-cell disorders (BCDs)
is usually easy based on clinical, morphologic, histopathologic,
immunophenotypic, and genetic features. However, all BCDs potentially
produce monoclonal IgM. In this study we reviewed the medical files of
130 patients with IgM-secreting BCDs. Eighty-four patients were
diagnosed with WM, 5 with IgM-monoclonal gammopathy of undetermined
significance (MGUS), and 41 with other BCDs (9 with B-cell chronic
lymphocytic leukemia, 5 with small lymphocytic lymphoma, 14 with
marginal zone lymphoma, 5 with mantle-cell lymphoma, 2 with follicular
lymphoma, 2 with diffuse large B-cell lymphoma, 2 with cryoglobulinemia,
and 2 with low-grade lymphoma not otherwise specified). Median IgM
levels were 3215 mg/dL in WM, 840 mg/dL in IgM-MGUS, and 285 mg/dL in
other BCDs (5 had IgM levels > 1500 mg/dL). In 10% of non-WM BCDs,
monoclonal IgM was found only when more sensitive immunofixation methods
were used. Forty-four percent of patients with BCDs (splenic marginal
zone lymphoma or small lymphocytic lymphoma) had diagnoses that
corresponded to that of WM. Careful diagnosis requires the concomitant
evaluation of all parameters of BCDs together. Marginal zone lymphoma is
the most frequently overlapping entity. Special attention should be
given to mantle cell lymphoma in its atypical forms. Research in this
field should continue to further clarify the disease entities that
overlap with WM. New technology such as gene-expression profile
techniques may contribute to this purpose.
Συγγραφείς:
Pangalis, GA
Kyrtsonis, MC
Kontopidou, FN
Siakantaris, MP
and Dimopoulou, MN
Vassilakopoulos, TP
Tzenou, T
Kokoris, S
and Dimitriadou, E
Kalpadakis, C
Tsalimalma, K
Tsaftaridis,
P
Panayiotidis, P
Angelopoulou, MK
Περιοδικό:
Clinical Lymphoma and Myeloma
Εκδότης:
Cancer Information Group, LP
Λέξεις-κλειδιά:
immunoglobulin M-secreting lymphoproliferative disorders; marginal zone
lymphoma; monoclonal immunoglobulin M
DOI:
10.3816/CLM.2005.n.006
