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Published on: October 14, 2021
Systemic CD5+ MALT lymphoma: presentation with Waldenstrom syndrome
Irina Mikolaenko1, Catherine M Listinsky
1Department of Pathology, Case Western Reserve University, Pathology Institute, Cleveland, OH 44106, USA. imikoles@aol.com
This study details a rare systemic MALT lymphoma case in a woman with neuropathy. The findings offer insights into the connections between MALT lymphoma, chronic lymphocytic leukemia, and Waldenstrom macroglobulinemia.
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Mucosa-associated lymphoid tissue (MALT) lymphoma is typically a localized B-cell neoplasm.
- Neuropathy associated with high immunoglobulin M levels can occur in lymphoproliferative disorders.
- Rheumatoid arthritis and polymyositis are autoimmune conditions that may be associated with lymphoproliferative disorders.
Observation:
- A 75-year-old woman presented with a submandibular salivary gland mass, neuropathy, and elevated serum immunoglobulin M.
- Histopathology revealed MALT lymphoma with characteristic lymphoepithelial lesions and plasma cells expressing immunoglobulin M lambda.
- Flow cytometry identified clonal mature B cells coexpressing dim CD5, an atypical finding for MALT lymphoma.
Findings:
- The patient's MALT lymphoma exhibited systemic distribution, involving bone marrow, lung, and lymph nodes.
- The immunoglobulin M lambda expression in plasma cells correlated with the observed serum spike.
- The coexpression of CD5 on malignant B cells suggests a potential link to chronic lymphocytic leukemia/small lymphocytic lymphoma.
Implications:
- This case highlights an unusual systemic presentation of MALT lymphoma.
- Understanding the relationship between MALT lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma, and Waldenstrom macroglobulinemia is crucial for diagnosis and treatment.
- Further research into CD5-positive MALT lymphomas may reveal new therapeutic targets.
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