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

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.