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[Waldenström macroglobulinemia complicated with chylothorax].
Sayaka Misaki1, Hiroto Sakoda, Saya Hakata
1Department of General Medicine, Sumitomo Hospital, Japan.
[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
|December 22, 2012
Summary
Waldenström macroglobulinemia (WM) can rarely cause chylothorax due to lymphoplasmacytic lymphoma (LPL) cell infiltration. Autopsy revealed LPL cell invasion of the heart and lymphatics, leading to arrhythmia, pneumothorax, and chylothorax.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Waldenström macroglobulinemia (WM) is a rare lymphoproliferative disorder.
- Complications of WM, such as chylothorax, are infrequently reported.
Observation:
- An 81-year-old male with a history of WM developed left chylothorax.
- Autopsy revealed extensive lymphoplasmacytic lymphoma (LPL) cell infiltration.
- LPL cells invaded the cardiac conduction system and induced lymphangiectasia.
Findings:
- Immunohistochemistry confirmed LPL cell infiltration in lung tissue.
- The LPL cells were positive for IgM and bcl-2.
- The case highlights a rare presentation of WM with chylothorax.
Implications:
- This case suggests LPL cell invasion may contribute to arrhythmia, pneumothorax, and chylothorax in WM patients.
- Understanding these rare complications is crucial for patient management.
- Further research into the mechanisms of LPL cell-induced lymphatic complications is warranted.
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