Lymphoplasmacytic lymphoma history and symptoms: Difference between revisions

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{{CMG}}; {{AE}}{{S.M.}}  
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==Overview==
==Overview==
Many patients with lymphoplasmacytic lymphoma are [[asymptomatic]]. The disease is subtle and symptoms are nonspecific. The most common symptoms of lymphoplasmacytic lymphoma include [[weakness]], [[anorexia]], [[Blurred vision|blurry vision]], [[peripheral neuropathy]], and [[weight loss]]. Less common symptoms of the disease include [[bleeding]] and [[Raynaud's phenomenon|Raynaud phenomenon]].
Many patients with [[lymphoplasmacytic lymphoma]] are [[asymptomatic]]. The [[disease]] is subtle and [[symptoms]] are nonspecific. The most common [[symptoms]] of [[lymphoplasmacytic lymphoma]] include [[weakness]], [[anorexia]], [[Blurred vision|blurry vision]], [[peripheral neuropathy]], and [[weight loss]]. Less common [[symptoms]] of the [[disease]] include [[bleeding]] and [[Raynaud's phenomenon|Raynaud phenomenon]].


==History and Symptoms==
==History and Symptoms==
=== History ===
=== History: ===
* The onset of lymphoplasmacytic lymphoma is insidious and non-specific.
* The onset of [[lymphoplasmacytic lymphoma]] is insidious and non-specific.
* Approximately 25% of patients with LPL are asymptomatic upon presentation; their diagnosis is often made [[Incidental finding|incidentally]] from routine blood tests done for some other reason. WM found this way is sometimes called asymptomatic or Smoldering WM (SWM).<ref name="pmid11736938">{{cite journal| author=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A et al.| title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. | journal=Br J Haematol | year= 2001 | volume= 115 | issue= 3 | pages= 575-82 | pmid=11736938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11736938  }} </ref>
* Approximately 25% of patients with LPL are [[asymptomatic]] upon presentation; their diagnosis is often made [[Incidental finding|incidentally]] from routine [[blood tests]] done for some other reason. WM found this way is sometimes called [[asymptomatic]] or Smoldering WM (SWM).<ref name="pmid11736938">{{cite journal| author=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A et al.| title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. | journal=Br J Haematol | year= 2001 | volume= 115 | issue= 3 | pages= 575-82 | pmid=11736938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11736938  }} </ref>
* Symptoms develop depending on the tissues involved in the malignant cell infiltration or [[IgM]] deposition.<ref name="pmid10623712">{{cite journal| author=Dimopoulos MA, Panayiotidis P, Moulopoulos LA, Sfikakis P, Dalakas M| title=Waldenström's macroglobulinemia: clinical features, complications, and management. | journal=J Clin Oncol | year= 2000 | volume= 18 | issue= 1 | pages= 214-26 | pmid=10623712 | doi=10.1200/JCO.2000.18.1.214 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10623712  }} </ref>
* [[Symptoms]] develop depending on the [[tissues]] involved in the [[malignant]] cell [[Infiltration (medical)|infiltration]] or [[IgM]] deposition.<ref name="pmid10623712">{{cite journal| author=Dimopoulos MA, Panayiotidis P, Moulopoulos LA, Sfikakis P, Dalakas M| title=Waldenström's macroglobulinemia: clinical features, complications, and management. | journal=J Clin Oncol | year= 2000 | volume= 18 | issue= 1 | pages= 214-26 | pmid=10623712 | doi=10.1200/JCO.2000.18.1.214 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10623712  }} </ref>
=== Manifestations of Lymphoplasmacytic lymphoma ===
=== Manifestations of Lymphoplasmacytic lymphoma: ===
Following is a list of LPL manifestations with attributable causes:<ref name="pmid15735132">{{cite journal| author=Dimopoulos MA, Kyle RA, Anagnostopoulos A, Treon SP| title=Diagnosis and management of Waldenstrom's macroglobulinemia. | journal=J Clin Oncol | year= 2005 | volume= 23 | issue= 7 | pages= 1564-77 | pmid=15735132 | doi=10.1200/JCO.2005.03.144 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15735132  }} </ref><ref name="DimopoulosPanayiotidis2000">{{cite journal|last1=Dimopoulos|first1=Meletios A.|last2=Panayiotidis|first2=Panayiotis|last3=Moulopoulos|first3=Lia A.|last4=Sfikakis|first4=Petros|last5=Dalakas|first5=Marinos|title=Waldenström’s Macroglobulinemia: Clinical Features, Complications, and Management|journal=Journal of Clinical Oncology|volume=18|issue=1|year=2000|pages=214–214|issn=0732-183X|doi=10.1200/JCO.2000.18.1.214}}</ref><ref name="pmid3110508">{{cite journal| author=Kyle RA, Garton JP| title=The spectrum of IgM monoclonal gammopathy in 430 cases. | journal=Mayo Clin Proc | year= 1987 | volume= 62 | issue= 8 | pages= 719-31 | pmid=3110508 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3110508  }} </ref><ref name="pmid12883242">{{cite journal| author=Lin P, Bueso-Ramos C, Wilson CS, Mansoor A, Medeiros LJ| title=Waldenstrom macroglobulinemia involving extramedullary sites: morphologic and immunophenotypic findings in 44 patients. | journal=Am J Surg Pathol | year= 2003 | volume= 27 | issue= 8 | pages= 1104-13 | pmid=12883242 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12883242  }} </ref><ref name="pmid8123836">{{cite journal| author=Dimopoulos MA, Alexanian R| title=Waldenstrom's macroglobulinemia. | journal=Blood | year= 1994 | volume= 83 | issue= 6 | pages= 1452-9 | pmid=8123836 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8123836  }} </ref><ref name="pmid6767276">{{cite journal| author=Fudenberg HH, Virella G| title=Multiple myeloma and Waldenström macroglobulinemia: unusual presentations. | journal=Semin Hematol | year= 1980 | volume= 17 | issue= 1 | pages= 63-79 | pmid=6767276 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6767276  }} </ref><ref name="pmid9671845">{{cite journal| author=Fadil A, Taylor DE| title=The lung and Waldenström's macroglobulinemia. | journal=South Med J | year= 1998 | volume= 91 | issue= 7 | pages= 681-5 | pmid=9671845 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9671845  }} </ref><ref name="pmid9198063">{{cite journal| author=Veltman GA, van Veen S, Kluin-Nelemans JC, Bruijn JA, van Es LA| title=Renal disease in Waldenström's macroglobulinaemia. | journal=Nephrol Dial Transplant | year= 1997 | volume= 12 | issue= 6 | pages= 1256-9 | pmid=9198063 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9198063  }} </ref><ref name="pmid10188670">{{cite journal| author=Daoud MS, Lust JA, Kyle RA, Pittelkow MR| title=Monoclonal gammopathies and associated skin disorders. | journal=J Am Acad Dermatol | year= 1999 | volume= 40 | issue= 4 | pages= 507-35; quiz 536-8 | pmid=10188670 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10188670  }} </ref><ref name="pmid6801795">{{cite journal| author=Orellana J, Friedman AH| title=Ocular manifestations of multiple myeloma, Waldenström's macroglobulinemia and benign monoclonal gammopathy. | journal=Surv Ophthalmol | year= 1981 | volume= 26 | issue= 3 | pages= 157-69 | pmid=6801795 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6801795  }} </ref><ref name="pmid9686227">{{cite journal| author=Civit T, Coulbois S, Baylac F, Taillandier L, Auque J| title=[Waldenström's macroglobulinemia and cerebral lymphoplasmocytic proliferation: Bing and Neel syndrome. Apropos of a new case]. | journal=Neurochirurgie | year= 1997 | volume= 43 | issue= 4 | pages= 245-9 | pmid=9686227 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9686227  }} </ref><ref name="pmid10357087">{{cite journal| author=Kwaan HC, Bongu A| title=The hyperviscosity syndromes. | journal=Semin Thromb Hemost | year= 1999 | volume= 25 | issue= 2 | pages= 199-208 | pmid=10357087 | doi=10.1055/s-2007-994921 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10357087  }} </ref><ref name="pmid3094151">{{cite journal| author=Farhangi M, Merlini G| title=The clinical implications of monoclonal immunoglobulins. | journal=Semin Oncol | year= 1986 | volume= 13 | issue= 3 | pages= 366-79 | pmid=3094151 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3094151  }} </ref><ref name="pmid2104668">{{cite journal| author=| title=Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 3-1990. A 66-year-old woman with Waldenström's macroglobulinemia, diarrhea, anemia, and persistent gastrointestinal bleeding. | journal=N Engl J Med | year= 1990 | volume= 322 | issue= 3 | pages= 183-92 | pmid=2104668 | doi=10.1056/NEJM199001183220308 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2104668  }} </ref><ref name="GertzKyle1993">{{cite journal|last1=Gertz|first1=M A|last2=Kyle|first2=R A|last3=Noel|first3=P|title=Primary systemic amyloidosis: a rare complication of immunoglobulin M monoclonal gammopathies and Waldenström's macroglobulinemia.|journal=Journal of Clinical Oncology|volume=11|issue=5|year=1993|pages=914–920|issn=0732-183X|doi=10.1200/JCO.1993.11.5.914}}</ref><ref name="pmid12720162">{{cite journal| author=Gertz MA, Kyle RA| title=Amyloidosis with IgM monoclonal gammopathies. | journal=Semin Oncol | year= 2003 | volume= 30 | issue= 2 | pages= 325-8 | pmid=12720162 | doi=10.1053/sonc.2003.50060 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12720162  }} </ref><ref name="pmid11530809">{{cite journal| author=Gardyn J, Schwartz A, Gal R, Lewinski U, Kristt D, Cohen AM| title=Waldenström's macroglobulinemia associated with AA amyloidosis. | journal=Int J Hematol | year= 2001 | volume= 74 | issue= 1 | pages= 76-8 | pmid=11530809 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11530809  }} </ref><ref name="pmid9603799">{{cite journal| author=Ropper AH, Gorson KC| title=Neuropathies associated with paraproteinemia. | journal=N Engl J Med | year= 1998 | volume= 338 | issue= 22 | pages= 1601-7 | pmid=9603799 | doi=10.1056/NEJM199805283382207 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9603799  }} </ref><ref name="pmid11556684">{{cite journal| author=Vital A| title=Paraproteinemic neuropathies. | journal=Brain Pathol | year= 2001 | volume= 11 | issue= 4 | pages= 399-407 | pmid=11556684 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11556684  }} </ref><ref name="pmid6807086">{{cite journal| author=Crisp D, Pruzanski W| title=B-cell neoplasms with homogeneous cold-reacting antibodies (cold agglutinins). | journal=Am J Med | year= 1982 | volume= 72 | issue= 6 | pages= 915-22 | pmid=6807086 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6807086  }} </ref><ref name="pmid6777101">{{cite journal| author=Lindström FD, Hed J, Eneström S| title=Renal pathology of Waldenström's macroglobulinaemia with monoclonal antiglomerular antibodies and nephrotic syndrome. | journal=Clin Exp Immunol | year= 1980 | volume= 41 | issue= 2 | pages= 196-204 | pmid=6777101 | doi= | pmc=1537007 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6777101  }} </ref><ref name="pmid15019332">{{cite journal| author=Sen HN, Chan CC, Caruso RC, Fariss RN, Nussenblatt RB, Buggage RR| title=Waldenström's macroglobulinemia-associated retinopathy. | journal=Ophthalmology | year= 2004 | volume= 111 | issue= 3 | pages= 535-9 | pmid=15019332 | doi=10.1016/j.ophtha.2003.05.036 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15019332  }} </ref>
Following is a list of LPL manifestations with attributable causes:<ref name="pmid15735132">{{cite journal| author=Dimopoulos MA, Kyle RA, Anagnostopoulos A, Treon SP| title=Diagnosis and management of Waldenstrom's macroglobulinemia. | journal=J Clin Oncol | year= 2005 | volume= 23 | issue= 7 | pages= 1564-77 | pmid=15735132 | doi=10.1200/JCO.2005.03.144 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15735132  }} </ref><ref name="DimopoulosPanayiotidis2000">{{cite journal|last1=Dimopoulos|first1=Meletios A.|last2=Panayiotidis|first2=Panayiotis|last3=Moulopoulos|first3=Lia A.|last4=Sfikakis|first4=Petros|last5=Dalakas|first5=Marinos|title=Waldenström’s Macroglobulinemia: Clinical Features, Complications, and Management|journal=Journal of Clinical Oncology|volume=18|issue=1|year=2000|pages=214–214|issn=0732-183X|doi=10.1200/JCO.2000.18.1.214}}</ref><ref name="pmid3110508">{{cite journal| author=Kyle RA, Garton JP| title=The spectrum of IgM monoclonal gammopathy in 430 cases. | journal=Mayo Clin Proc | year= 1987 | volume= 62 | issue= 8 | pages= 719-31 | pmid=3110508 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3110508  }} </ref><ref name="pmid12883242">{{cite journal| author=Lin P, Bueso-Ramos C, Wilson CS, Mansoor A, Medeiros LJ| title=Waldenstrom macroglobulinemia involving extramedullary sites: morphologic and immunophenotypic findings in 44 patients. | journal=Am J Surg Pathol | year= 2003 | volume= 27 | issue= 8 | pages= 1104-13 | pmid=12883242 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12883242  }} </ref><ref name="pmid8123836">{{cite journal| author=Dimopoulos MA, Alexanian R| title=Waldenstrom's macroglobulinemia. | journal=Blood | year= 1994 | volume= 83 | issue= 6 | pages= 1452-9 | pmid=8123836 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8123836  }} </ref><ref name="pmid6767276">{{cite journal| author=Fudenberg HH, Virella G| title=Multiple myeloma and Waldenström macroglobulinemia: unusual presentations. | journal=Semin Hematol | year= 1980 | volume= 17 | issue= 1 | pages= 63-79 | pmid=6767276 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6767276  }} </ref><ref name="pmid9671845">{{cite journal| author=Fadil A, Taylor DE| title=The lung and Waldenström's macroglobulinemia. | journal=South Med J | year= 1998 | volume= 91 | issue= 7 | pages= 681-5 | pmid=9671845 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9671845  }} </ref><ref name="pmid9198063">{{cite journal| author=Veltman GA, van Veen S, Kluin-Nelemans JC, Bruijn JA, van Es LA| title=Renal disease in Waldenström's macroglobulinaemia. | journal=Nephrol Dial Transplant | year= 1997 | volume= 12 | issue= 6 | pages= 1256-9 | pmid=9198063 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9198063  }} </ref><ref name="pmid10188670">{{cite journal| author=Daoud MS, Lust JA, Kyle RA, Pittelkow MR| title=Monoclonal gammopathies and associated skin disorders. | journal=J Am Acad Dermatol | year= 1999 | volume= 40 | issue= 4 | pages= 507-35; quiz 536-8 | pmid=10188670 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10188670  }} </ref><ref name="pmid6801795">{{cite journal| author=Orellana J, Friedman AH| title=Ocular manifestations of multiple myeloma, Waldenström's macroglobulinemia and benign monoclonal gammopathy. | journal=Surv Ophthalmol | year= 1981 | volume= 26 | issue= 3 | pages= 157-69 | pmid=6801795 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6801795  }} </ref><ref name="pmid9686227">{{cite journal| author=Civit T, Coulbois S, Baylac F, Taillandier L, Auque J| title=[Waldenström's macroglobulinemia and cerebral lymphoplasmocytic proliferation: Bing and Neel syndrome. Apropos of a new case]. | journal=Neurochirurgie | year= 1997 | volume= 43 | issue= 4 | pages= 245-9 | pmid=9686227 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9686227  }} </ref><ref name="pmid10357087">{{cite journal| author=Kwaan HC, Bongu A| title=The hyperviscosity syndromes. | journal=Semin Thromb Hemost | year= 1999 | volume= 25 | issue= 2 | pages= 199-208 | pmid=10357087 | doi=10.1055/s-2007-994921 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10357087  }} </ref><ref name="pmid3094151">{{cite journal| author=Farhangi M, Merlini G| title=The clinical implications of monoclonal immunoglobulins. | journal=Semin Oncol | year= 1986 | volume= 13 | issue= 3 | pages= 366-79 | pmid=3094151 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3094151  }} </ref><ref name="pmid2104668">{{cite journal| author=| title=Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 3-1990. A 66-year-old woman with Waldenström's macroglobulinemia, diarrhea, anemia, and persistent gastrointestinal bleeding. | journal=N Engl J Med | year= 1990 | volume= 322 | issue= 3 | pages= 183-92 | pmid=2104668 | doi=10.1056/NEJM199001183220308 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2104668  }} </ref><ref name="GertzKyle1993">{{cite journal|last1=Gertz|first1=M A|last2=Kyle|first2=R A|last3=Noel|first3=P|title=Primary systemic amyloidosis: a rare complication of immunoglobulin M monoclonal gammopathies and Waldenström's macroglobulinemia.|journal=Journal of Clinical Oncology|volume=11|issue=5|year=1993|pages=914–920|issn=0732-183X|doi=10.1200/JCO.1993.11.5.914}}</ref><ref name="pmid12720162">{{cite journal| author=Gertz MA, Kyle RA| title=Amyloidosis with IgM monoclonal gammopathies. | journal=Semin Oncol | year= 2003 | volume= 30 | issue= 2 | pages= 325-8 | pmid=12720162 | doi=10.1053/sonc.2003.50060 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12720162  }} </ref><ref name="pmid11530809">{{cite journal| author=Gardyn J, Schwartz A, Gal R, Lewinski U, Kristt D, Cohen AM| title=Waldenström's macroglobulinemia associated with AA amyloidosis. | journal=Int J Hematol | year= 2001 | volume= 74 | issue= 1 | pages= 76-8 | pmid=11530809 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11530809  }} </ref><ref name="pmid9603799">{{cite journal| author=Ropper AH, Gorson KC| title=Neuropathies associated with paraproteinemia. | journal=N Engl J Med | year= 1998 | volume= 338 | issue= 22 | pages= 1601-7 | pmid=9603799 | doi=10.1056/NEJM199805283382207 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9603799  }} </ref><ref name="pmid11556684">{{cite journal| author=Vital A| title=Paraproteinemic neuropathies. | journal=Brain Pathol | year= 2001 | volume= 11 | issue= 4 | pages= 399-407 | pmid=11556684 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11556684  }} </ref><ref name="pmid6807086">{{cite journal| author=Crisp D, Pruzanski W| title=B-cell neoplasms with homogeneous cold-reacting antibodies (cold agglutinins). | journal=Am J Med | year= 1982 | volume= 72 | issue= 6 | pages= 915-22 | pmid=6807086 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6807086  }} </ref><ref name="pmid6777101">{{cite journal| author=Lindström FD, Hed J, Eneström S| title=Renal pathology of Waldenström's macroglobulinaemia with monoclonal antiglomerular antibodies and nephrotic syndrome. | journal=Clin Exp Immunol | year= 1980 | volume= 41 | issue= 2 | pages= 196-204 | pmid=6777101 | doi= | pmc=1537007 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6777101  }} </ref><ref name="pmid15019332">{{cite journal| author=Sen HN, Chan CC, Caruso RC, Fariss RN, Nussenblatt RB, Buggage RR| title=Waldenström's macroglobulinemia-associated retinopathy. | journal=Ophthalmology | year= 2004 | volume= 111 | issue= 3 | pages= 535-9 | pmid=15019332 | doi=10.1016/j.ophtha.2003.05.036 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15019332  }} </ref>


{| class="wikitable"
{| class="wikitable"
|+ '''Manifestations of Lymphoplasmacytic lymphoma'''
|+ '''Manifestations of [[Lymphoplasmacytic lymphoma]]'''
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Cause
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Cause
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Manifestations
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Manifestations
|-
|-
| style="background:#DCDCDC;" align="center" + |Tumor infiltration
| style="background:#DCDCDC;" align="center" + |[[Tumor]] [[Infiltration (medical)|infiltration]]
| style="background:#F5F5F5;" align="center" + |Cytopenia, fever, night sweats, weight loss, lymphadenopathy, hepatomegaly, spleenomegaly, pulmonary infiltrates, nodules or masses, pleural effusion, abdominal pain, swelling and blood in stools secondary to stomach and bowel infiltration, renal and perirenal masses, maculopapular lesions, plaques or nodules secondary to dermis infiltration, lesions involving retro-orbital lymphoid tissue and lacrimal glands, infiltration of the conjunctiva and malignant vitreitis, Bing-Neel syndrome consists of confusion, memory loss, disorientation, motor dysfunction, and eventually coma.
| style="background:#F5F5F5;" align="center" + |[[Cytopenia]], [[fever]], [[night sweats]], [[weight loss]], [[lymphadenopathy]], [[hepatomegaly]], [[Splenomegaly|spleenomegaly]], [[pulmonary]] infiltrates, [[nodules]] or masses, [[pleural effusion]], [[abdominal pain]], [[swelling]] and [[blood]] in [[stools]] secondary to [[stomach]] and [[bowel]] infiltration, [[renal]] and perirenal masses, [[maculopapular]] lesions, [[plaques]] or [[nodules]] secondary to [[dermis]] infiltration, lesions involving retro-orbital [[lymphoid tissue]] and [[lacrimal glands]], infiltration of the [[conjunctiva]] and [[malignant]] vitreitis, [[Bing-Neel syndrome]] consists of [[confusion]], [[memory loss]], [[disorientation]], motor dysfunction, and eventually [[coma]].
|-
|-
| style="background:#DCDCDC;" align="center" + |Circulating monoclonal IgM
| style="background:#DCDCDC;" align="center" + |Circulating monoclonal [[IgM]]
| style="background:#F5F5F5;" align="center" + |Hyperviscosity syndrome, Type 1 Cryoglobulinemia (consists of Raynaud's phenomenon, skin ulcers & necrosis and cold urticaria), frequent bruising, prolonged bleeding and clotting times.
| style="background:#F5F5F5;" align="center" + |[[Hyperviscosity syndrome]], Type 1 [[Cryoglobulinemia]] (consists of [[Raynaud's phenomenon]], skin [[ulcers]] & [[necrosis]] and [[cold urticaria]]), frequent [[bruising]], prolonged [[bleeding]] and [[clotting]] times.
|-
|-
| style="background:#DCDCDC;" align="center" + |IgM deposition into tissues
| style="background:#DCDCDC;" align="center" + |[[IgM]] deposition into [[tissues]]
| style="background:#F5F5F5;" align="center" + |Sub-endothelial deposits in glomerular loops leading to non-selective proteinuria, dehydration, and uremia, Firm, flesh-colored skin papules and nodules have been reported and are called macroglobulinemia cutis, Diarrhea, malabsorption, or gastrointestinal bleeding.  
| style="background:#F5F5F5;" align="center" + |Sub-endothelial deposits in glomerular loops leading to non-selective [[proteinuria]], [[dehydration]], and [[uremia]], Firm, flesh-colored skin [[papules]] and [[nodules]] have been reported and are called [[macroglobulinemia]] cutis, [[Diarrhea]], [[malabsorption]], or [[gastrointestinal bleeding]].  
|-
|-
| style="background:#DCDCDC;" align="center" + |Amyloidogenic properties of IgM
| style="background:#DCDCDC;" align="center" + |[[Amyloidogenic]] properties of [[IgM]]
| style="background:#F5F5F5;" align="center" + |Organs more commonly affected by amyloidosis were the heart (44%) associated with unexplained cardiac failure, the peripheral nerves (38%), the kidneys (32%), the soft tissues (18%), the liver (14%), and lungs (10%), nephrotic syndrome and gastrointestinal involvement leading to intestinal dysmotility. Purpura and macroglossia can also occur secondary to AL amyloidosis.
| style="background:#F5F5F5;" align="center" + |[[Organs]] more commonly affected by [[amyloidosis]] were the [[heart]] (44%) associated with unexplained [[cardiac failure]], the [[peripheral nerves]] (38%), the [[kidneys]] (32%), the soft tissues (18%), the [[liver]] (14%), and [[lungs]] (10%), [[nephrotic syndrome]] and [[gastrointestinal]] involvement leading to [[intestinal]] dysmotility. [[Purpura]] and [[macroglossia]] can also occur secondary to [[AL amyloidosis]].
|-
|-
| style="background:#DCDCDC;" align="center" + |Autoantibody activity of IgM
| style="background:#DCDCDC;" align="center" + |[[Autoantibody]] activity of [[IgM]]
| style="background:#F5F5F5;" align="center" + |Distal, symmetric, chronic myelin-associated glycoprotein antibody-positive demyelinating peripheral neuropathy, Type 2 cryoglobulinemia characterized by vasculitis affecting small vessels of skin, kidneys, liver, and peripheral nerves, Extravascular chronic hemolytic anemia called cold agglutinin disease exacerbated by cold exposure, glomerulonephritis, paraneoplastic pemphigus, and retinitis/retinopathy.  
| style="background:#F5F5F5;" align="center" + |[[Distal]], symmetric, chronic [[myelin]]-associated [[glycoprotein]] [[antibody]]-positive [[demyelinating]] [[peripheral neuropathy]], Type 2 [[cryoglobulinemia]] characterized by [[vasculitis]] affecting small vessels of [[skin]], [[kidneys]], [[liver]], and [[peripheral nerves]], Extravascular [[chronic hemolytic anemia]] called [[cold agglutinin disease]] exacerbated by [[cold exposure]], [[glomerulonephritis]], [[paraneoplastic]] [[pemphigus]], and [[retinitis]]/[[retinopathy]].  
|}
|}
==== Common Symptoms ====
==== Common Symptoms: ====
Common symptoms of lymphoplasmacytic lymphoma include:<ref name="pmid11736938">{{cite journal| author=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A et al.| title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. | journal=Br J Haematol | year= 2001 | volume= 115 | issue= 3 | pages= 575-82 | pmid=11736938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11736938  }} </ref><ref name="pmid12720138">{{cite journal| author=Merlini G, Baldini L, Broglia C, Comelli M, Goldaniga M, Palladini G et al.| title=Prognostic factors in symptomatic Waldenstrom's macroglobulinemia. | journal=Semin Oncol | year= 2003 | volume= 30 | issue= 2 | pages= 211-5 | pmid=12720138 | doi=10.1053/sonc.2003.50064 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12720138  }} </ref>
Common [[symptoms]] of [[lymphoplasmacytic lymphoma]] include:<ref name="pmid11736938">{{cite journal| author=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A et al.| title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. | journal=Br J Haematol | year= 2001 | volume= 115 | issue= 3 | pages= 575-82 | pmid=11736938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11736938  }} </ref><ref name="pmid12720138">{{cite journal| author=Merlini G, Baldini L, Broglia C, Comelli M, Goldaniga M, Palladini G et al.| title=Prognostic factors in symptomatic Waldenstrom's macroglobulinemia. | journal=Semin Oncol | year= 2003 | volume= 30 | issue= 2 | pages= 211-5 | pmid=12720138 | doi=10.1053/sonc.2003.50064 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12720138  }} </ref>
* [[B symptoms|Constitutional B symptoms]] as seen in other types of NHL:
* [[B symptoms|Constitutional B symptoms]] as seen in other types of [[NHL]]:
**[[Weakness]] (due to normocytic anemia associated with IgM binding to RBCs).
**[[Weakness]] (due to [[normocytic anemia]] associated with [[IgM]] binding to [[RBCs]]).
**[[Anorexia]].
**[[Anorexia]].
**Unexplained [[weight loss]].
**Unexplained [[weight loss]].
**Unexplained [[fever]].
**Unexplained [[fever]].
**Heavy sweating, especially at night causing drenching of one's cloths and bedsheet.
**Heavy [[sweating]], especially at night causing drenching of one's cloths and bedsheet.
**Severe/extensive skin itchiness.
**Severe/extensive skin [[itchiness]].
*Fatigue.
*[[Fatigue]].
*Sensorimotor [[peripheral neuropathy]] (mostly associated with numbness and tingling, i.e. painful pins and needle sensation, of the fingers or toes).
*[[Sensorimotor]] [[peripheral neuropathy]] (mostly associated with [[numbness]] and [[tingling]], i.e. [[painful]] pins and needle sensation, of the fingers or toes).
*[[Blurred vision|Blurry vision]] or blind spots.
*[[Blurred vision|Blurry vision]] or [[blind]] spots.
*Abdominal pain.
*[[Abdominal pain]].


==== Less Common Symptoms ====
==== Less Common Symptoms: ====
Less common symptoms of lymphoplasmacytic lymphoma include:<ref name="pmid11736938">{{cite journal| author=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A et al.| title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. | journal=Br J Haematol | year= 2001 | volume= 115 | issue= 3 | pages= 575-82 | pmid=11736938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11736938  }} </ref><ref name="pmid12720138">{{cite journal| author=Merlini G, Baldini L, Broglia C, Comelli M, Goldaniga M, Palladini G et al.| title=Prognostic factors in symptomatic Waldenstrom's macroglobulinemia. | journal=Semin Oncol | year= 2003 | volume= 30 | issue= 2 | pages= 211-5 | pmid=12720138 | doi=10.1053/sonc.2003.50064 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12720138  }} </ref>
Less common [[symptoms]] of [[lymphoplasmacytic lymphoma]] include:<ref name="pmid11736938">{{cite journal| author=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A et al.| title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. | journal=Br J Haematol | year= 2001 | volume= 115 | issue= 3 | pages= 575-82 | pmid=11736938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11736938  }} </ref><ref name="pmid12720138">{{cite journal| author=Merlini G, Baldini L, Broglia C, Comelli M, Goldaniga M, Palladini G et al.| title=Prognostic factors in symptomatic Waldenstrom's macroglobulinemia. | journal=Semin Oncol | year= 2003 | volume= 30 | issue= 2 | pages= 211-5 | pmid=12720138 | doi=10.1053/sonc.2003.50064 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12720138  }} </ref>
*Enlarged lymph nodes (appearing as 1-2 inches sized lumps under the skin in neck, groin or the armpits).
*[[Enlarged lymph nodes]] (appearing as 1-2 inches sized lumps under the skin in neck, groin or the armpits).
*Swollen belly/abdomen (due to hepatosplenomegaly).
*Swollen belly/abdomen (due to [[hepatosplenomegaly]]).
*Pain or a feeling of fullness below the ribs on the left side.
*Pain or a feeling of fullness below the ribs on the left side.
*Painless lumps in the neck, underarm, stomach, or groin
*Painless lumps in the neck, underarm, stomach, or groin
*Headache.
*[[Headache]].
*Raised pink/flesh-colored lesions on skin.
*Raised pink/flesh-colored lesions on skin.
*Altered mental status due to decreased blood flow and infiltration of CNS leading to:
*[[Altered mental status]] due to decreased blood flow and infiltration of [[CNS]] leading to:
**[['''Bing–Neel syndrome|Bing-Neel syndrome''']] which includes:
**[[Bing-Neel syndrome]] which includes:
***[[Confusion]].
***[[Confusion]].
***Dizziness.
***[[Dizziness]].
***[[Memory loss]].
***[[Memory loss]].
***[[Motor disorders]].
***[[Motor disorders]].
*Symptoms resembling stroke like slurred speech or weakness on one side of body (such patients are advised to consult from their doctor right away).
*[[Symptoms]] resembling [[stroke]] like [[slurred speech]] or [[weakness]] on one side of body (such patients are advised to consult from their doctor right away).
*Abnormal mucous membrane bleeding (epistaxis, bleeding gums).
*Abnormal [[mucous membrane]] [[bleeding]] ([[epistaxis]], [[bleeding gums]]).
*Vision problems (blurred vision, double vision or blind spots).
*[[Vision problems]] ([[blurred vision]], [[double vision]] or [[blind]] spots).
*Kidney problems (leading to weakness, trouble breathing and fluid buildup in body tissues associated with accumulation of excess salt, fluid and waste products in blood secondary to amyloidosis).  
*[[Kidney]] problems (leading to [[weakness]], trouble [[breathing]] and fluid buildup in body tissues associated with accumulation of excess salt, fluid and waste products in blood secondary to [[amyloidosis]]).  
*Heart problems (Secondary to amyloidosis, build up of M protein in heart affects its pumping ability, and also the heart has to work harder to pump the thick blood ultimately leading to CHF with following symptoms).
*[[Heart]] problems (Secondary to [[amyloidosis]], build up of [[M protein]] in [[heart]] affects its pumping ability, and also the heart has to work harder to pump the thick blood ultimately leading to [[CHF]] with following symptoms).
**Palpitations.
**[[Palpitations]].
**Feeling of tiredness and weakness.
**Feeling of [[tiredness]] and [[weakness]].
**Cough.
**[[Cough]].
**Shortness of breath.
**[[Shortness of breath]].
**Rapid weight gain.
**Rapid [[weight gain]].
**Swelling of feet and legs.
**[[Swelling]] of feet and legs.
*Infections (high levels of abnormal antibody in WM slows down the production of normal antibodies).
*[[Infections]] (high levels of abnormal [[antibody]] in WM slows down the production of normal [[antibodies]]).
*Digestive problems due to deposition of IgM protein in the [[lamina propria]] of the [[intestinal wall]] include:
*[[Digestive]] problems due to deposition of [[IgM]] protein in the [[lamina propria]] of the [[intestinal wall]] include:
**Diarrhea.
**[[Diarrhea]].
**Poor absorption of vitamins.
**Poor absorption of [[vitamins]].
**GIT bleeding/[[steatorrhea]] (blood in stools/dark stools).
**[[GIT]] bleeding/[[steatorrhea]] (blood in stools/dark stools).
*Sensitivity to cold ([[Raynaud's phenomenon]] due to [[cryoglobulinemia]] in 5% WM patients), which is associated with reduced blood flow leading to pain, itching, bluish discoloration or sores in following body parts:
*Sensitivity to cold ([[Raynaud's phenomenon]] due to [[cryoglobulinemia]] in 5% WM patients), which is associated with reduced blood flow leading to [[pain]], [[itching]], [[Bluish discoloration of the skin|bluish discoloration]] or sores in following body parts:
**Tip of nose.
**Tip of nose.
**Ears.
**Ears.
**Fingers.
**Fingers.
**Toes.
**Toes.
*Clinical manifestations of '''cryoglobulinemia''' include:
*Clinical manifestations of '''[[cryoglobulinemia]]''' include:
**Numbness and tingling in hands and feet.
**[[Numbness]] and [[tingling]] in hands and feet.
**Joint aches.
**[[Joint aches]].
**Small bruises.
**Small [[bruises]].
**Skin ulcers.
**Skin [[ulcers]].
**Purpura.
**[[Purpura]].
**Digital ischemia.
**Digital [[ischemia]].
**Arthralgia.
**[[Arthralgia]].
**Fever.
**[[Fever]].
**Raynaud phenomenon.
**[[Raynaud phenomenon]].
*Clinical manifestations of '''Cold agglutinin disease''' include:
*Clinical manifestations of '''[[Cold agglutinin disease]]''' include:
**Livido reticularis.
**[[Livedo reticularis]].
**Acrocyanosis.
**[[Acrocyanosis]].
**Raynaud phenomenon.
**[[Raynaud's phenomenon|Raynaud phenomenon]].


==== Symptoms Secondary to Hyperviscosity Syndrome ====
==== Symptoms Secondary to Hyperviscosity Syndrome: ====
The lymphoma cells make varying amounts of a monoclonal protein called immunoglobulin M (IgM, or macroglobulin). Higher amounts of this protein than normal in blood tends to make it thick leading to [[hyperviscosity syndrome]] which occurs in approximately 15-20% patients of WM. When blood becomes thick, it is harder for blood to flow through small blood vessels, and when this occurs, the condition is termed as Waldenstrom macroglobulinemia. This excess amount of IgM antibodies can be ultimately associated with circulatory problems leading to less blood flow to the brain, the eyes or other organs.Clinical manifestations of hyperviscosity syndrome occur only if serum [[viscosity]] is >4 centipoises and include:<ref name="pmid11736938">{{cite journal| author=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A et al.| title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. | journal=Br J Haematol | year= 2001 | volume= 115 | issue= 3 | pages= 575-82 | pmid=11736938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11736938  }} </ref>
The [[lymphoma]] cells make varying amounts of a monoclonal protein called [[immunoglobulin M]] ([[IgM]], or [[macroglobulin]]). Higher amounts of this protein than normal in blood tends to make it thick leading to [[hyperviscosity syndrome]] which occurs in approximately 15-20% patients of WM. When blood becomes thick, it is harder for blood to flow through small blood vessels, and when this occurs, the condition is termed as [[Waldenström's macroglobulinemia|Waldenstrom macroglobulinemia]]. This excess amount of IgM [[antibodies]] can be ultimately associated with circulatory problems leading to less blood flow to the brain, the eyes or other organs.Clinical manifestations of [[hyperviscosity syndrome]] occur only if serum [[viscosity]] is >4 centipoises and include:<ref name="pmid11736938">{{cite journal| author=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A et al.| title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases. | journal=Br J Haematol | year= 2001 | volume= 115 | issue= 3 | pages= 575-82 | pmid=11736938 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11736938  }} </ref>
*Symptoms resembling those of [[stroke]].
*Symptoms resembling those of [[stroke]].
* Retinal [[hemorrhage]] with [[Blurred vision|blurring of vision]]/loss of vision.
* [[Retinal]] [[hemorrhage]] with [[Blurred vision|blurring of vision]]/loss of vision.
*[[Vertigo]].
*[[Vertigo]].
*[[Dizziness]].
*[[Dizziness]].
Line 110: Line 110:
*[[Ataxia]].
*[[Ataxia]].
* [[Bleeding]].
* [[Bleeding]].
*Shortness of breath.
*[[Shortness of breath]].
*Numbness and tingling of the fingers or toes (called peripheral neuropathy).
*[[Numbness]] and [[tingling]] of the fingers or toes (called [[peripheral neuropathy]]).
*Muscle weakness.
*[[Muscle weakness]].
*Confusion.
*[[Confusion]].
*Not all people with LPL develop hyperviscosity, cryoglobulins, or amyloidosis.
*Not all people with LPL develop [[hyperviscosity]], [[cryoglobulins]], or [[amyloidosis]].


==References==
==References==

Revision as of 19:43, 19 February 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2]

Overview

Many patients with lymphoplasmacytic lymphoma are asymptomatic. The disease is subtle and symptoms are nonspecific. The most common symptoms of lymphoplasmacytic lymphoma include weakness, anorexia, blurry vision, peripheral neuropathy, and weight loss. Less common symptoms of the disease include bleeding and Raynaud phenomenon.

History and Symptoms

History:

Manifestations of Lymphoplasmacytic lymphoma:

Following is a list of LPL manifestations with attributable causes:[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]

Manifestations of Lymphoplasmacytic lymphoma
Cause Manifestations
Tumor infiltration Cytopenia, fever, night sweats, weight loss, lymphadenopathy, hepatomegaly, spleenomegaly, pulmonary infiltrates, nodules or masses, pleural effusion, abdominal pain, swelling and blood in stools secondary to stomach and bowel infiltration, renal and perirenal masses, maculopapular lesions, plaques or nodules secondary to dermis infiltration, lesions involving retro-orbital lymphoid tissue and lacrimal glands, infiltration of the conjunctiva and malignant vitreitis, Bing-Neel syndrome consists of confusion, memory loss, disorientation, motor dysfunction, and eventually coma.
Circulating monoclonal IgM Hyperviscosity syndrome, Type 1 Cryoglobulinemia (consists of Raynaud's phenomenon, skin ulcers & necrosis and cold urticaria), frequent bruising, prolonged bleeding and clotting times.
IgM deposition into tissues Sub-endothelial deposits in glomerular loops leading to non-selective proteinuria, dehydration, and uremia, Firm, flesh-colored skin papules and nodules have been reported and are called macroglobulinemia cutis, Diarrhea, malabsorption, or gastrointestinal bleeding.
Amyloidogenic properties of IgM Organs more commonly affected by amyloidosis were the heart (44%) associated with unexplained cardiac failure, the peripheral nerves (38%), the kidneys (32%), the soft tissues (18%), the liver (14%), and lungs (10%), nephrotic syndrome and gastrointestinal involvement leading to intestinal dysmotility. Purpura and macroglossia can also occur secondary to AL amyloidosis.
Autoantibody activity of IgM Distal, symmetric, chronic myelin-associated glycoprotein antibody-positive demyelinating peripheral neuropathy, Type 2 cryoglobulinemia characterized by vasculitis affecting small vessels of skin, kidneys, liver, and peripheral nerves, Extravascular chronic hemolytic anemia called cold agglutinin disease exacerbated by cold exposure, glomerulonephritis, paraneoplastic pemphigus, and retinitis/retinopathy.

Common Symptoms:

Common symptoms of lymphoplasmacytic lymphoma include:[1][25]

Less Common Symptoms:

Less common symptoms of lymphoplasmacytic lymphoma include:[1][25]

Symptoms Secondary to Hyperviscosity Syndrome:

The lymphoma cells make varying amounts of a monoclonal protein called immunoglobulin M (IgM, or macroglobulin). Higher amounts of this protein than normal in blood tends to make it thick leading to hyperviscosity syndrome which occurs in approximately 15-20% patients of WM. When blood becomes thick, it is harder for blood to flow through small blood vessels, and when this occurs, the condition is termed as Waldenstrom macroglobulinemia. This excess amount of IgM antibodies can be ultimately associated with circulatory problems leading to less blood flow to the brain, the eyes or other organs.Clinical manifestations of hyperviscosity syndrome occur only if serum viscosity is >4 centipoises and include:[1]

References

  1. 1.0 1.1 1.2 1.3 García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A; et al. (2001). "Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases". Br J Haematol. 115 (3): 575–82. PMID 11736938.
  2. Dimopoulos MA, Panayiotidis P, Moulopoulos LA, Sfikakis P, Dalakas M (2000). "Waldenström's macroglobulinemia: clinical features, complications, and management". J Clin Oncol. 18 (1): 214–26. doi:10.1200/JCO.2000.18.1.214. PMID 10623712.
  3. Dimopoulos MA, Kyle RA, Anagnostopoulos A, Treon SP (2005). "Diagnosis and management of Waldenstrom's macroglobulinemia". J Clin Oncol. 23 (7): 1564–77. doi:10.1200/JCO.2005.03.144. PMID 15735132.
  4. Dimopoulos, Meletios A.; Panayiotidis, Panayiotis; Moulopoulos, Lia A.; Sfikakis, Petros; Dalakas, Marinos (2000). "Waldenström's Macroglobulinemia: Clinical Features, Complications, and Management". Journal of Clinical Oncology. 18 (1): 214–214. doi:10.1200/JCO.2000.18.1.214. ISSN 0732-183X.
  5. Kyle RA, Garton JP (1987). "The spectrum of IgM monoclonal gammopathy in 430 cases". Mayo Clin Proc. 62 (8): 719–31. PMID 3110508.
  6. Lin P, Bueso-Ramos C, Wilson CS, Mansoor A, Medeiros LJ (2003). "Waldenstrom macroglobulinemia involving extramedullary sites: morphologic and immunophenotypic findings in 44 patients". Am J Surg Pathol. 27 (8): 1104–13. PMID 12883242.
  7. Dimopoulos MA, Alexanian R (1994). "Waldenstrom's macroglobulinemia". Blood. 83 (6): 1452–9. PMID 8123836.
  8. Fudenberg HH, Virella G (1980). "Multiple myeloma and Waldenström macroglobulinemia: unusual presentations". Semin Hematol. 17 (1): 63–79. PMID 6767276.
  9. Fadil A, Taylor DE (1998). "The lung and Waldenström's macroglobulinemia". South Med J. 91 (7): 681–5. PMID 9671845.
  10. Veltman GA, van Veen S, Kluin-Nelemans JC, Bruijn JA, van Es LA (1997). "Renal disease in Waldenström's macroglobulinaemia". Nephrol Dial Transplant. 12 (6): 1256–9. PMID 9198063.
  11. Daoud MS, Lust JA, Kyle RA, Pittelkow MR (1999). "Monoclonal gammopathies and associated skin disorders". J Am Acad Dermatol. 40 (4): 507–35, quiz 536-8. PMID 10188670.
  12. Orellana J, Friedman AH (1981). "Ocular manifestations of multiple myeloma, Waldenström's macroglobulinemia and benign monoclonal gammopathy". Surv Ophthalmol. 26 (3): 157–69. PMID 6801795.
  13. Civit T, Coulbois S, Baylac F, Taillandier L, Auque J (1997). "[Waldenström's macroglobulinemia and cerebral lymphoplasmocytic proliferation: Bing and Neel syndrome. Apropos of a new case]". Neurochirurgie. 43 (4): 245–9. PMID 9686227.
  14. Kwaan HC, Bongu A (1999). "The hyperviscosity syndromes". Semin Thromb Hemost. 25 (2): 199–208. doi:10.1055/s-2007-994921. PMID 10357087.
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