Waldenström's macroglobulinemia with unilateral massive pleural effusion: report of a case

One rare case of Waldenström's macroglobulinemia with massive right-sided pleural effusion is reported. A 66-year-old woman was admitted to our hospital because of exertional dyspnea and chronic cough of three months' duration. Chest X-ray examination showed massive right-sided pleural effusion. Routine blood examination revealed severe anemia. Sternal bone marrow aspirate revealed a hypercellular marrow with replacement of 50% of the normal hematopoietic cells by a spectrum of lymphoid cells, including small lymphocytes, a few plasma-cytoid lymphocytes and immature plasma cells. The diagnosis was confirmed by serum protein electrophoresis and immunoglobulin assay. The effect of chemotherapy was satisfactory in the first two years as pleural effusion subsided completely and the marrow returned to near normal. But, the response was poor during the last 6 months. She died about 4 years after her first admission.