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Cutaneous Waldenstrom macroglobulinemia in transformation.
P Appenzeller1, C P Leith, K Foucar
1Department of Pathology, University of New Mexico Health Sciences Center, Albuquerque, USA.
The American Journal of Dermatopathology
|April 28, 1999
Summary
Waldenstrom macroglobulinemia rarely presents with skin lesions, and even more rarely transforms into high-grade lymphoma. This report details two unusual cases of Waldenstrom macroglobulinemia with skin involvement and transformation to high-grade lymphoma.
Area of Science:
- Hematology
- Oncology
- Dermatology
Background:
- Waldenstrom macroglobulinemia (WM) is a rare, indolent B-cell lymphoproliferative neoplasm.
- WM typically involves the bone marrow, lymph nodes, and spleen, with nonspecific cutaneous manifestations.
- Specific skin lesions in WM are uncommon, usually presenting as papules of monoclonal IgM deposits.
Observation:
- This study presents two rare cases of elderly men with pre-existing WM.
- Both patients developed cutaneous manifestations of WM.
- These skin lesions subsequently transformed into high-grade lymphoma.
Findings:
- The reported cases demonstrate an unusual progression of WM with skin involvement and transformation to high-grade lymphoma.
- Distinguishing transformed WM from de novo cutaneous large cell lymphoma is crucial due to potential biological differences.
Implications:
- Highlights the rare but significant possibility of cutaneous involvement and transformation in Waldenstrom macroglobulinemia.
- Emphasizes the need for careful evaluation of skin lesions in WM patients for potential high-grade transformation.
- Suggests that transformed WM may represent a distinct clinicopathological entity requiring specific diagnostic and therapeutic considerations.