Does Waldenstrom's macroglobulinemia also cause bone destruction? A rare case report

Area of Science:

• Hematology
• Oncology
• Pathology

Background:

• Waldenstrom's macroglobulinemia (WM) is a rare B-cell lymphoma characterized by elevated serum IgM.
• Distinguishing WM from multiple myeloma (MM) often relies on the rarity of bone lesions in WM.

Observation:

• This report details a unique case of WM where a vertebral compression fracture was the initial presenting symptom.
• This observation challenges the traditional diagnostic criteria differentiating WM and MM based on bone involvement.

Findings:

• The presence or absence of bone destruction is not a definitive feature to distinguish between WM and MM.
• Vertebral fractures can be the primary manifestation of WM.

Implications:

• Clinicians should consider WM in patients presenting with vertebral fractures and destruction, even if initially suspected as MM.
• Vertebral bone marrow aspiration biopsy during percutaneous vertebroplasty offers a practical approach for diagnosing WM in these scenarios.