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Case Reports
. 2022 Jun 29;29(7):4587-4592.
doi: 10.3390/curroncol29070363.

Concurrent Waldenstrom's Macroglobulinemia and Myelodysplastic Syndrome with a Sequent t(10;13)(p13;q22) Translocation

Peter A DeRosa  1 , Kyle C Roche  2 , Victor E Nava  3   4 , Sunita Singh  5 , Min-Ling Liu  3   4 , Anita Agarwal  6   7
Affiliations
Case Reports

Concurrent Waldenstrom's Macroglobulinemia and Myelodysplastic Syndrome with a Sequent t(10;13)(p13;q22) Translocation

Peter A DeRosa et al. Curr Oncol. .

Abstract

Myelodysplastic syndromes (MDS) and Waldenstrom's macroglobulinemia (WM) are rarely synchronous. Ineffective myelopoiesis/hematopoiesis with clonal unilineage or multilineage dysplasia and cytopenias characterize MDS. Despite a myeloid origin, MDS can sometimes lead to decreased production, abnormal apoptosis or dysmaturation of B cells, and the development of lymphoma. WM includes bone marrow involvement by lymphoplasmacytic lymphoma (LPL) secreting monoclonal immunoglobulin M (IgM) with somatic mutation (L265P) of myeloid differentiation primary response 88 gene (MYD88) in 80-90%, or various mutations of C-terminal domain of the C-X-C chemokine receptor type 4 (CXCR4) gene in 20-40% of cases. A unique, progressive case of concurrent MDS and WM with several somatic mutations (some unreported before) and a novel balanced reciprocal translocation between chromosomes 10 and 13 is presented below.

Keywords: cytogenetics; genetics; hematology/oncology; lymphoma; myelodysplastic syndrome; pathology.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Initial diagnostic bone marrow biopsy and aspirate. The marrow is markedly hypercellular with diffuse lymphoid infiltrates consisting of predominant small lymphocytes, plasmacytic lymphocytes and rare plasma cells (H&E at 20× and 400×, respectively, in (A) and (B)). In the background, there is maturing trilineage hematopoiesis with dysmegakaryopoiesis and few blasts ((C). H and E at 1000×) and erythroid hyperplasia with dysplasia ((D) Wright-Giemsa stained aspirate at 1000×). (Scale bars = 2 mm in magnification at 20×, 50 μm at 400×, and 25 μm at magnification 1000×).
Figure 2
Figure 2
Immunohistochemistry of the initial bone marrow biopsy showing the lymphoplasmacytic lymphoma to be positive for Pax5 (A) and negative for CD5 (B) with a plasmacytic component negative for kappa (C) and positive for lambda (D). (Scale bars = 50 μm at magnification 400×).
Figure 3
Figure 3
Treatment timeline during patient’s clinical course.
See this image and copyright information in PMC

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