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Waldenström's Macroglobulinemia as a Diagnostic Challenge: Case Report

Ivan Budimir
Marko Nikolić
Mateja Sabol Pušić
Davor Hrabar
Neven Ljubičić
Marko Duvnjak
Vladimir Supanc
Ivana Nikolac
Nenad Babić
Marija Šokčević

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page 94-97

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Waldenström’s macroglobulinemia is a distinct clinicopathologic entity defined as a B-cell neoplasm characterized by lymphoplasmacytic infiltrate in the bone marrow, with an associated immunoglobulin (Ig) M paraprotein. Clinical manifestations are due to deposition of IgM in the liver, spleen, and/or lymph nodes, so it presents with anemia, hyperviscosity, lymphadenopathy, hepatomegaly, splenomegaly and neurologic symptoms. The main diagnostic criteria are a typical peak on serum protein electrophoresis and malignant cells in bone marrow biopsy samples. There is no standard therapy for the treatment of symptomatic Waldenström’s macroglobulinemia and no agents have been specifically approved for this disease, but initial treatment usually starts with the monoclonal anti-CD20 antibody rituximab, either alone or in combination with other
agents, rather than chemotherapy alone. This article confirms that, despite the existence of more modern imaging methods, ultrasonography still has a significant diagnostic role.


Waldenström macroglobulinemia; B-lymphocytes; Immunogobulin M; Antibodies, monoclonal; Ultrasonography

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