Clinical and pathologic features of Waldenström's macroglobulinemia in seven patients with serum monoclonal IgG or IgA

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      The clinical, hematologic and pathologic findings in seven patients were similar to those of Waldenström's macroglobulinemia, but unexpectedly the serum monoclonal immunoglobulin belonged to the IgG class in five patients and to the IgA class in two. The bone marrow and lymph node lymphoid proliferation was pleomorphic, with the simultaneous presence of small lymphocytes, normal mature plasma cells and transitional lymphoplasmacytic cells. Immunofluorescence studies showed that a monoclonal immunoglobulin similar to that found in the serum was detectable on the membrane or in the cytoplasm of all the proliferating cells, which thus belonged to the same B cell clone. The study of these patients is in accordance with the concept that lymphoid disorders featured by a pleomorphic monoclonal B cell proliferation constitute a distinct clinicopathologic entity, which is not restricted to IgM-producing clones.
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        • Preud'Homme JL
        • Seligmann M
        Surface-bound immunoglobulins as a cell marker in human lymphoproliferative diseases.
        Blood. 1972; 40: 777
        • Salmon SE
        • Seligmann M
        B-cell neoplasia in man.
        Lancet. 1974; 2: 1230
        • Seligmann M
        • Preud'homme JL
        • Brouet JC
        B and T cell markers in human proliferative blood diseases and primary immunodeficiencies: with special reference to membrane bound immunoglobulins.
        Transplant Rev. 1973; 16: 85
        • Maldonado JE
        • Kyle RA
        • Brown AL
        • et al.
        “Intermediate” cell types and mixed cell proliferation in multiple myeloma.
        Blood. 1966; 27: 212
        • Mellstedt H
        • Hammarström S
        • Holm G
        Monoclonal lymphocyte population in human plasma cell myeloma.
        Clin Exp Immunol. 1974; 17: 371
        • Lindström FD
        • Hardy WR
        • Eberle BJ
        • et al.
        Multiple myeloma and benign monoclonal gammapathy: differentiation by immunofluorescence of lymphocytes.
        Ann Intern Med. 1973; 78: 837
        • Preud'homme JL
        • Hurez D
        • Danon F
        • et al.
        Intracytoplasmic and surface bound immunoglobulins in “nonsecretory” and Bence Jones myeloma.
        Clin Exp Immunol. 1976; 25: 478
        • Azar HA
        • Hill WT
        • Osserman EF
        Malignant lymphoma and lymphatic leukemia associated with myeloma-type serum proteins.
        Am J Med. 1957; 23: 239
        • Alexanian R
        Monoclonal gammopathy in lymphoma.
        Arch Intern Med. 1975; 135: 62
        • Preud'homme JL
        • Seligmann M
        Immunoglobulins on the surface of lymphoid cells in Waldenströms macroglobulinemia.
        J Clin Invest. 1972; 51: 701
        • Hijmans W
        Waldenström's disease with an IgA paraprotein.
        Acta Med Scand. 1975; 198: 519
        • Waldenström J
        Clinical diagnosis and biochemical findings in material of 296 sera with M-type narrow γ-globulins.
        Acta Med Scand suppl. 1961; 367: 110
        • Welton J
        • Walker SR
        • Sharp GC
        • et al.
        Macroglobulinemia with bone destruction.
        Am J Med. 1968; 44: 280
        • Hobbs J.R.
        Immunochemical classes of myelomatosis.
        Br J Haemat. 1969; 16: 599
        • Clark C
        • Rydell RE
        • Kaplan ME
        Frequent association of IgM λ with crystalline inclusions of chronic lymphocytic leukemia lymphocytes.
        N Engl J Med. 1973; 285: 113
        • Klein E
        • Nilsson K
        • Yefenoff E
        An established Burkitts lymphoma line with cell membrane IgG.
        Clin Immunol Immunopathol. 1975; 3: 575
        • Seligmann M
        Alpha-chain disease.
        J Clin Pathol. 1975; 28 (suppl): 72