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Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
Published on: May 7, 2019
Waldenstrom's macroglobulinemia presenting with spinal cord compression: a case report
Hani Al-Halabi1, David Roberge
1Division of Radiation Oncology, Sir Mortimer B Davis Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
American Journal of Hematology
|August 5, 2006
Summary
Waldenstrom's macroglobulinemia (WM) can present unusually. This case highlights spinal cord compression as the initial symptom, differing from typical presentations.
Area of Science:
- Hematology
- Oncology
- Neurology
Background:
- Waldenstrom's macroglobulinemia (WM) is a rare lymphoplasmacytic lymphoma.
- Typical WM presentations include cytopenia, hepatosplenomegaly, lymphadenopathy, constitutional symptoms, and hyperviscosity syndrome.
- The disease involves IgM production and tumor infiltration.
Observation:
- An 81-year-old man presented with severe back pain, lacking common WM symptoms like lymphadenopathy or hepatosplenomegaly.
- Spinal MRI revealed an epidural mass causing T9 spinal cord compression.
- Pathological analysis identified a lymphoproliferative B-cell process.
Findings:
- Bone marrow analysis confirmed WM with lymphoid/lymphoplasmacytoid infiltrate and elevated serum IgM.
- The patient showed clinical and serological response to radiotherapy.
- This represents the first reported case of WM initially presenting as epidural spinal cord compression.
Implications:
- This case expands the known clinical spectrum of Waldenstrom's macroglobulinemia.
- Highlights the importance of considering rare presentations in diagnosing WM.
- Underscores the need for thorough diagnostic workup even in atypical initial symptoms.
