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Multilobated nuclei in Waldenström' macroglobulinaemia.
G Metzgeroth1, Ch Sick, O Maywald
1III Medizinische Universitätsklinik, Fakultät für Klinische Medizin Mannheim, University of Heidelberg, Mannheim, Germany.
European Journal of Haematology
|September 3, 2003
Summary
This case study details Waldenström's macroglobulinaemia with unusual multilobulated cells. The patient responded well to chemotherapy, leading to remission and improved health.
Area of Science:
- Hematology
- Oncology
- Cell Biology
Background:
- Waldenström's macroglobulinaemia is a rare B-cell lymphoproliferative disorder.
- Bone marrow infiltration by heterogeneous cell populations can present diagnostic challenges.
Observation:
- A patient with Waldenström's macroglobulinaemia exhibited bone marrow infiltration by small lymphoplasmacytoid cells (80%) and large atypical cells with multilobulated nuclei (20%).
- Both cell types were CD19+, CD38+, and IgM+.
- Fluorescence in situ hybridization indicated that the multilobulated nuclei were diploid and likely originated from a single nucleus.
Findings:
- The unusual multilobulated cell population was found to be diploid.
- Unlike typical multiple myeloma cases, this patient demonstrated a favorable response to chemotherapy.
- Post-chemotherapy, the lymphoma morphology shifted to typical lymphoplasmacytoid lymphoma, with the disappearance of the multilobulated cells.
Implications:
- This case highlights the potential for unusual cellular morphologies in Waldenström's macroglobulinaemia.
- The findings suggest that chemotherapy can be effective in cases with complex cellular presentations.
- The diploid nature of the multilobulated nuclei provides insights into their origin and behavior.