title: Waldenstrom macroglobulinemia presenting as a pleural effusion.
abstract: We describe a patient with Waldenstrom macroglobulinemia who presented with a lymphocytic pleural effusion. Pleural involvement in Waldenstrom macroglobulinemia is very rare. In addition, to our knowledge, there are no reports in the literature in which a primary diagnosis was made on the basis of pleural fluid analysis. The presence of small lymphocytes in serous cavity fluid can pose great difficulty in the differentiation between a low-grade lymphoproliferative disorder and reactive lymphocytosis. The diagnosis of malignancy in this case was established on the basis of morphologic testing, flow cytometry, and the detection of B-cell immunoglobulin gene rearrangement.
authors.affiliation: Department of Pathology, George Washington University Hospital and School of Medicine, Washington, DC 20037, USA.
authors.forename: A
authors.initials: A
authors.lastname: Mansoor
authors.forename: R P
authors.initials: RP
authors.lastname: Wagner
authors.forename: L
authors.initials: L
authors.lastname: DePalma
mesh_terms: D000368:Aged; D015703:Antigens, CD / Q000032:analysis; D018941:Antigens, CD19 / Q000032:analysis; D001402:B-Lymphocytes / Q000276:immunology / Q000473:pathology; D003937:Diagnosis, Differential; D005434:Flow Cytometry; D015321:Gene Rearrangement; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D008297:Male; D010996:Pleural Effusion / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D008258:Waldenstrom Macroglobulinemia / Q000097:blood / Q000175:diagnosis* / Q000235:genetics
chemical_list: D015703:Antigens, CD; D018941:Antigens, CD19; D007143:Immunoglobulin Heavy Chains