华氏巨球蛋白血症合并胸腔积液1例报告并文献复习

张睿; 吴涛; 毛东锋; 周芮; 李芸芸; 高铭敏; 王向丽; 刘洋

doi:10.16766/j.cnki.issn.1674-4152.004557

华氏巨球蛋白血症合并胸腔积液1例报告并文献复习

doi: 10.16766/j.cnki.issn.1674-4152.004557

中国人民解放军联勤保障部队第九四〇医院（原兰州军区兰州总医院）全军血液病中心，甘肃兰州 730050

基金项目:

甘肃省创新基地和人才计划项目 21JR7RA015

联勤保障部队第九四〇医院血液病医学研究中心项目 2021yxky078

甘肃省重点研发计划项目 22YF7FA106

甘肃省科技计划项目青年科技基金 23JRRA1674

甘肃省科技计划项目 25JRRA1184

详细信息

通讯作者:
吴涛，E-mail：wutaozhen@yeah.net

中图分类号: R733 R553
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出版历程
- 收稿日期: 2025-02-19
- 网络出版日期: 2026-11-10

A case report and literature review of Waldenström macroglobulinemia with pleural effusion

Department of Hematology, Center for Hematologic Diseases of Chinese PLA, the 940th Hospital of Joint Logistics Support force of Chinese People's Liberation Army (Lanzhou Military Command General Hospital), Lanzhou, Gansu 730050, China

摘要

摘要: 本文报道了1例以呼吸困难及剑突下胀痛为首发症状的华氏巨球蛋白血症(WM)罕见病例。通过回顾性分析该患者的临床资料并结合相关文献复习发现，WM的临床表现具有高度异质性，极易造成漏诊或误诊。本例患者经过骨髓穿刺、淋巴结病理检查、免疫固定电泳及胸水流式细胞术等综合手段，最终明确诊断。治疗上采用利妥昔单抗联合新型BTK抑制剂泽布替尼方案，术后患者胸腔积液显著减少，病情趋于稳定。该病例提示临床医生在面对不典型浆细胞样淋巴瘤症状时，应加强对WM鉴别诊断的重视，结合多模态实验室检查以提高早期确诊率。
- 淋巴浆细胞淋巴瘤/华氏巨球蛋白血症 /
- IgM /
- MYD88 L265P /
- CXCR4
Abstract: This study reports a rare case of Waldenström's macroglobulinemia (WM) in a patient presenting with dyspnea and subxiphoid distending pain as the primary symptoms. A retrospective analysis of the clinical data was conducted alongside a comprehensive literature review to delineate the clinical manifestations, pathological characteristics, and diagnostic challenges associated with WM. The patient was diagnosed through a multifaceted approach, including bone marrow aspiration, histopathological examination of lymph node lesions, immunofixation electrophoresis, and flow cytometry of pleural effusion. Following a therapeutic regimen of Rituximab combined with Zanubrutinib, the patient's pleural effusion significantly decreased, and the clinical condition stabilized. This case emphasizes the clinical heterogeneity of WM and underscores the necessity for clinicians to employ integrated diagnostic techniques to reduce misdiagnosis and delayed diagnosis of this malignancy.
- Lymphoplasmacytic lymphoma/Waldenström macroglobulinemia /
- IgM /
- MYD88 L265P /
- CXCR4

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参考文献(19)

[1]	中国抗癌协会血液肿瘤专业委员会, 中华医学会血液学分会, 中国华氏巨球蛋白血症工作组. 淋巴浆细胞淋巴瘤/华氏巨球蛋白血症诊断与治疗中国指南(2022年版)[J]. 中华血液学杂志, 2022, 43(8): 624-630. Hematology Oncology Committee of China Anti-Cancer Association, Chinese Society of Hematology, Chinese Medical Association, Chinese Working Group of Walderström Macroglobulinemia. Chinese guideline for diagnosis and treatment of lymphoplasmacytic lymphoma/Walderström macroglobulinemia (2022)[J]. Chinese Journal of Hematology, 2022, 43(8): 624-630.
[2]	GERTZ M A. Waldenstr m macroglobulinemia: 2023 update on diagnosis, risk stratification, and management[J]. Am J Hematol, 2023, 98(2): 348-358. doi: 10.1002/ajh.26796
[3]	陈菲萌, 乔淑凯, 郭晓楠. 浆细胞白血病的临床特征及诊治进展[J]. 白血病·淋巴瘤, 2022, 31(6): 381-384. Chen F M, Qiao S K, Guo X N. Clinical characteristics of plasma cell leukemia and progress in its diagnosis and treatment[J]. Journal of Leukemia and Lymphoma, 2022, 31(6): 381-384.
[4]	GERTZ M A. Waldenstr m Macroglobulinemia: 2025 update on diagnosis, risk stratification, and management[J]. Am J Hematol, 2025, 100(6): 1061-1071. doi: 10.1002/ajh.27666
[5]	易树华, 熊文婕, 曹欣欣, 等. 中国华氏巨球蛋白血症诊断与治疗现状调查: 一项横断面研究[J]. 中华血液学杂志, 2024, 45(2): 148-155. Yi S H, Xiong W J, Cao X X, et al. Diagnosis and treatment understanding of Waldenstr?m macroglobulinemia in China: a cross-sectional study[J]. Chinese Journal of Hematology, 2024, 45(2): 148-155.
[6]	张婷, 黄俊霞, 高燕, 等. 单克隆IgM升高的B细胞/浆细胞肿瘤3例报告及文献复习[J]. 青岛大学学报(医学版), 2021, 57(3): 459-462. Zhang T, Huang J X, Gao Y, et al. B-CELL/PLASMA cell tumor with elewated monoclonal IgM: a report of three cases and literature review[J]. Acta Aacademiae Medicinae Qingdao Universitatis, 2021, 57(3): 459-462.
[7]	YAN Y, YU Y, XIONG W, et al. Determination of MYD88 and CXCR4 mutations for clinical detection and their significance in Waldenstr m Macroglobulinemia[J]. Clin Cancer Res, 2024, 30(23): 5483-5493. doi: 10.1158/1078-0432.CCR-23-3939
[8]	KAISER L M, HARMS M, SAUTER D, et al. Targeting of CXCR4 by the naturally occurring CXCR4 antagonist EPI-X4 in Waldenstr m's Macroglobulinemia[J]. Cancers (Basel), 2021, 13(4): 826. DOI: 10.3390/cancers13040826.
[9]	MORENO D F, LÓPEZ-GUERRA M, PAZ S, et al. Prognostic impact of MYD88 and CXCR4 mutations assessed by droplet digital polymerase chain reaction in IgM monoclonal gammopathy of undetermined significance and smouldering Waldenstr m macroglobulinaemia[J]. Br J Haematol, 2023, 200(2): 187-196. doi: 10.1111/bjh.18502
[10]	FERRANTE M, FURLAN D, ZIBELLINIi S, et al. MYD88(L265P) detection in IgM monoclonal gammopathies: methodological considerations for routine implementation[J]. Diagnostics(Basel), 2021, 11(5): 779. DOI: 10.3390/diagnostics11050779.
[11]	QIU L, LIN P. Lymphoplasmacytic lymphoma and Waldenstr m macroglobulinemia, a decade after the discovery of MYD88(L265P)[J]. Hum Pathol, 2025, 156: 105708. DOI: 10.1016/j.humpath.2024.105708.
[12]	BUSKE C, JURCZAK W, SALEM J E, et al. Managing Waldenstr m's macroglobulinemia with BTK inhibitor[J]. Leukemia, 2023, 37(1): 35-46. doi: 10.1038/s41375-022-01732-9
[13]	汉英, 石亚军, 吴涛. 弥漫大B细胞淋巴瘤合并淋巴浆细胞淋巴瘤/华氏巨球蛋白血症伴IgM及IgG共存的临床研究[J]. 检验医学与临床, 2024, 21(11): 1655-1659. Han Y, Shi Y J, Wu T. Clinical study of diffuse large B-cell lymphoma combined with lymphoplasmacytic lymphoma/Waldenstr?m macroglobulinemia with biclclonic IgM and IgG[J]. Laboratory Medicine and Clinic, 2024, 21(11): 1655-1659.
[14]	GERTZ M A. Waldenstr m macroglobulinemia: 2021 update on diagnosis, risk stratification, and management[J]. Am J Hematol, 2021, 96(2): 258-269. doi: 10.1002/ajh.26082
[15]	刘亚宁, 李焱, 任利涛, 等. 苯达莫司汀联合R-CHOP方案对弥漫大B细胞淋巴瘤疗效及安全性的影响[J]. 中华全科医学, 2024, 22(7): 1150-1153. doi: 10.16766/j.cnki.issn.1674-4152.003587 Liu Y N, Li Y, Ren L T, et al. Effects of bendamustine combined with R-CHOP on the efficacy and safety of diffuse large B-cell lymphoma[J]. Chinese Journal of General Practice, 2024, 22(7): 1150-1153. doi: 10.16766/j.cnki.issn.1674-4152.003587
[16]	CHAN W L, CHONG V C L, WEE I J Y, et al. Efficacy and safety of front-line treatment regimens for Waldenstr m macroglobulinaemia: a systematic review and meta-analysis[J]. Blood Cancer J, 2023, 13(1): 140. DOI: 10.1038/s41408-023-00916-5.
[17]	TREON S P, SAROSIEK S, CASTILLO J J. How I use genomics and BTK inhibitors in the treatment of Waldenstr m macroglobulinemia[J]. Blood, 2024, 143(17): 1702-1712. doi: 10.1182/blood.2022017235
[18]	LU R M, HWANG Y C, LIU I J, et al. Development of therapeutic antibodies for the treatment of diseases[J]. J BIOMED SCI, 2020, 27(1): 1-30.
[19]	PEREZ DE ACHA O, REIMAN L, JAYABALAN D S, et al. CD38 antibody re-treatment in daratumumab-refractory multiple myeloma after time on other therapies[J]. Blood Adv, 2023, 7(21): 6430-6440. doi: 10.1182/bloodadvances.2023010162

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华氏巨球蛋白血症合并胸腔积液1例报告并文献复习

doi: 10.16766/j.cnki.issn.1674-4152.004557

通讯作者:
吴涛，E-mail：wutaozhen@yeah.net

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A case report and literature review of Waldenström macroglobulinemia with pleural effusion

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华氏巨球蛋白血症合并胸腔积液1例报告并文献复习

doi: 10.16766/j.cnki.issn.1674-4152.004557

通讯作者: 吴涛，E-mail：wutaozhen@yeah.net

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出版历程

A case report and literature review of Waldenström macroglobulinemia with pleural effusion

计量

出版历程

目录

通讯作者:
吴涛，E-mail：wutaozhen@yeah.net