Primary lung involvement in Waldenstrom's macroglobulinaemia - Report of two cases and review of the literature

Pulmonary involvement in Waldenstrom's macroglobulinaemia (WM) occurs in 3- 5% of cases, but lung involvement without bone marrow infiltration is extre mely rare, We report 2 patients who presented with bilateral consolidations on chest X-ray and non-specific symptoms and were treated for a long perio d of time for pulmonary infections until the diagnosis was made by open lun g biopsy, Both patients presented high monoclonal IgM in the serum and one also had blood lymphoplasmacytosis. Trephine bone biopsy and bone marrow sm ears were normal and there was no other site of involvement. Along with the presentation of our patients, we review the literature, discuss some of th e possible underlying mechanisms and raise the attention of clinicians to t his rare manifestation of the disease. Copyright (C) 2001 S. Karger AG, Bas el.