At a Glance
Lymphoplasmacytic lymphoma is a low grade small B-cell non-Hodgkin lymphoma that has a monoclonal B-cell and a monoclonal plasma cell component. Most patients with lymphoplasmacytic lymphoma have Waldenström macroglobulinemia, which is lymphoplasmacytic lymphoma involving the bone marrow and IgM monoclonal gammopathy. It occurs in adults with a median age of 60 at diagnosis. It is slightly more common in men.
What Tests Should I Request to Confirm My Clinical Dx? In addition, what follow-up tests might be useful?
Lymphoplasmacytic lymphoma is diagnosed by a combination of clinical and pathological findings. Patients may present with a variety of clinical signs and symptoms, but some common laboratory findings are anemia, an IgM paraprotein (usually IgM kappa), hyperviscosity, cryoglobulinemia, and coagulopathy. Bone marrow biopsy is the most common way to diagnose lymphoplasmacytic lymphoma.
Flow cytometry studies are very helpful to identify the monoclonal B-cell and plasma cell populations. Cytogenetic studies are usually performed, but there is no specific chromosomal or oncogenic abnormality that characterizes lymphoplasmacytic lymphoma. No specific fluorescence in situ hybridization (FISH) testing is done, unless there is a concern for another type of lymphoma with a specific chromosomal translocation. Molecular polymerase chain reaction (PCR) studies to look for IgH gene rearrangements are not routinely done.
Are There Any Factors That Might Affect the Lab Results? In particular, does your patient take any medications - OTC drugs or Herbals - that might affect the lab results?
Sometimes, distinguishing between lymphoplasmacytic lymphoma and other small B-cell lymphomas, such as marginal zone lymphoma, is difficult. A patient may receive a diagnosis of "small B-cell lymphoma with plasmacytic differentiation" when this is the case. Waldenström macroglobulinemia can run in families. Hepatitis C viral infection is associated with lymphoplasmacytic lymphoma and type II cryoglobulinemia. Patients with lymphoplasmacytic lymphoma with Waldenstrom macroglobulinemia can develop autoimmune phenomena, hyperviscosity, cryoglobulinemia, coagulopathy, skin abnormalities, and diarrhea thought to be due to the IgM paraprotein. Sometimes, the spleen, lymph nodes, liver, and peripheral blood are involved by lymphoplasmacytic lymphoma.
Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.
No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.
Next Article in LabMed
Neurology Advisor Articles
- OCD in Duchenne Muscular Dystrophy Features Distinct Phenotype, Associated Symptoms
- History of Migraine Associated With Higher Risk for Cochlear Disorders
- Vagus Nerve Stimulation in Pediatric Epilepsy: Weighing the Risks and Benefits
- A Model for Predicting Quality of Life Improvements After Deep Brain Stimulation
- High Treatment Adherence and Quality of Life Observed With Fingolimod
- Some Statins May Be Associated With Cognition, Memory Deficits
- Neuropathic Pain Treatments
- Cannabis for Multiple Sclerosis: Prescriber's Perspective
- New Monoclonal Antibody BAN2401 Reduces Amyloid Plaques, Improves Cognition in Alzheimer's
- Nonpharmacologic Interventions for Alzheimer's Have Greater Impact on Outcomes Than Currently Available Medications
- Population-Based Incidence of Acute Idiopathic Optic Neuritis Estimated
- First-in-Class Therapy Approved for Polyneuropathy Caused by hATTR
- High Anxiety Symptoms Prevalent in Epilepsy, Mesial Temporal Sclerosis
- Advance Care Planning Doesn't Aid Quality of Life
- Variation in Specialty Drug Coverage Across Health Plans