Case history
Case history #1
A 65-year-old white man, whose father died from lymphoma, presents with worsening fatigue, anorexia, and weight loss over the past 6 months. Blood test reveals anemia, but iron, vitamin B12, folate, and other hematinics are normal.
Case history #2
A 70-year-old white man with a long history of worsening fatigue, unsteady gait, and intermittent numbness and pins-and-needles sensation in his lower legs, presents to the emergency department with epistaxis, headache, and vision problems. His family says he has started to become confused recently. Physical exam reveals small-volume axillary and inguinal lymphadenopathy. Fundoscopy reveals a retinal hemorrhage in the right eye.
Other presentations
The most common presenting symptoms are fatigue and anorexia.[4] However, symptoms may range from being asymptomatic to being acutely ill with symptoms of hyperviscosity and infections secondary to impaired immunity. There are no pathognomonic features for WM. However, the absence of lytic bone lesions and the presence of lymphadenopathy and splenomegaly in WM can differentiate it from multiple myeloma. In addition, multiple myeloma is usually associated with a different type of monoclonal protein to WM (e.g., IgG, IgA, IgD, IgE, or a light chain [kappa or lambda]); IgM multiple myeloma is very rare.
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