Waldenstrom巨球蛋白血症的诊断(附16例报告)

The Diagnose and Treatment of Waldenstrom's Macroglobulinemia

目的 探讨Waldenstrom巨球蛋白血症的诊断。方法 回顾性分析 1986年— 2 0 0 0年收治的 16例Waldenstrom巨球蛋白血症病人的临床和实验室资料。结果 本组病人诊断时中位年龄 6 7岁 ,主要临床特征为血清中IgM异常增高及骨髓和淋巴结内淋巴样浆细胞浸润。初诊时有 9例误诊 ,误诊率 5 6 2 5 %。结论 为减少误诊 ,应提高对该病的认识 ,重视免疫学检查和鉴别诊断 ,血清IgM测定和骨髓学检查应做为本病的常规检查。

Objective To explore the diagnose and treatment of Waldenstrom's macroglobulinemia (WM). Methods A retrospectire analysis was made of 16 cases of WM from 1986 to 2000 in the 88 th hospital of PLA and Changhai hospital of second military medical university. Results The median age at diagnosis was 67 years. There were such clinical characteristics in this disease as the presence of an IgM monoclonal protein in serum and the infiltration of lymphocytes and plasma cells in the bone marrow. The misdiagnosis rate was 56.25(9/16). Conclusion To decrease the misdiagnosis, the clinicians must pay attention to distinguish monoclonal gammopathy of undetermined significance (MGUS), multiple myeloma, chronic lymphocytic leukemia from WM and heighten the vigilance for WM. The detection of serum IgM, the examination of bone marrow can be used for diagnosis and differential diagnosis of WM.