Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website https://www.jocmr.org

Case Report

Volume 16, Number 4, April 2024, pages 189-195

Successful Implementation of Combined Treatment Methods for a Rare Recurrence of Waldenstrom Macroglobulinemia With Extramedullary Lesions

Figures

Figure 1.
Figure 1. (a, b) Isodose distribution of radiation volume of patient G., who was 67 years old, with the diagnosis of Waldenstrom macroglobulinemia with extramedullary lesion (frontal and axial sections).
Figure 2.
Figure 2. Dose-volume histogram of the radiation therapy plan of patient G., who was 67 years old, with a diagnosis of Waldenstrom macroglobulinemia with extramedullary lesion. According to the control brain MRI with contrasting, a positive trend was noted in the form of a decrease in intracranial formations of the meninges of the brain in the right temporal and parietal region, and in the left temporal-fronto-parietal region. MRI: magnetic resonance imaging.

Table

Table 1. Frequency of the Main Clinical and Laboratory Manifestations of Waldenstrom Disease
 
SymptomFrequency, %
Ig: immunoglobulin; ESR: erythrocyte sedimentation rate.
Lympho-plasma cell infiltration of bone marrow100
Monoclonal Ig M100
M-component in paper/agarose electrophoresis71/100
ESR increase (> 30 mm/h)87
Hyperproteinemia (> 90 g/L)60
Weight loss49
Anemia (often with normal serum iron levels, absence of laboratory signs of hemolysis)
  90 - 120 g/L67
  ≤ 90 g/L40
Clinical manifestations of protein-pathology syndrome (microcirculatory disorders, decreased visual acuity, hemorrhagic symptoms)40, 4
IgM-retinopathy38
Hemorrhagic syndrome (without thrombocytopenia)33
Hepatomegaly31
Splenomegaly30
Peripheral lymphadenopathy26
Reduced serum iron level25, 5
Thrombocytopenia (< 100 × 109)18
Absolute lymphocytosis12, 8
Peripheral polyneuropathy12
Arthralgia, arthropathia12
Osteodestruction6
Hyperleukocytosis (> 9 × 109)4, 8
Skin itching2, 4