Clinical Report: Concurrent Lymphoplasmacytic Lymphoma and Multiple Myeloma
Background
LPL and MM are distinct B-cell neoplasms, with synchronous occurrence being extremely rare. Understanding this overlap is crucial for accurate diagnosis and treatment planning.
Data Highlights
Finding
Value
Hemoglobin
44 g/L
MCV
79.5 fL
Platelets
81×10^9/L
Total Protein
90.5 g/L
Globulin
71.1 g/L
M-spike
48.8 g/L
MYD88 Mutation VAF
40.00%
CXCR4 Mutation VAF
15.53%
Key Findings
The patient presented with fatigue and bone pain, with laboratory findings indicating severe anemia and thrombocytopenia.
Serum immunofixation revealed dual IgG-kappa and IgM-kappa monoclonal proteins.
Bone marrow analysis showed two distinct B-cell populations, confirming the presence of both LPL and MM.
Next-generation sequencing confirmed MYD88 and CXCR4 mutations, supporting the diagnosis of LPL.
The patient was treated with zanubrutinib, bortezomib, and dexamethasone, achieving a partial response.
Definitive proof of biclonality would require sorted-cell molecular studies.
Clinical Implications
This case emphasizes the need for careful diagnostic evaluation when LPL and MM are suspected. Integration of clinical, immunophenotypic, and molecular data is essential for accurate diagnosis and management.
Conclusion
The coexistence of LPL and MM presents significant diagnostic challenges. Further studies are needed to explore the implications of this overlap in clinical practice.
