What are the physical exam findings of Waldenström macroglobulinemia?

Updated: Feb 01, 2021
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

The physical findings result from tissue infiltration by the malignant clone, the hyperviscosity state caused by antigen-antibody reactions triggered by the paraprotein, and derangement of the hemostatic system by the paraprotein. Hepatosplenomegaly and lymphadenopathy are common. Merlini et al [22] reported the following occurrences of symptoms in 215 patients evaluated for Waldenström macroglobulinemia:

  • Hepatomegaly - 20%

  • Splenomegaly - 19%

  • Lymphadenopathy - 15%

  • Purpura - 9%

  • Hemorrhagic manifestations - 7%

Papilledema, ie, sausage-shaped (distended and tortuous) retinal veins, and hemorrhages may be evident on funduscopic examination.


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