Correspondence

Case 27-2001: Waldenström's Macroglobulinemia

N Engl J Med 2002; 346:784March 7, 2002

Article

To the Editor:

In Case Record 27-2001 (Aug. 30 issue),1 Table 1 and the discussion by Dr. Noopur Raje contain errors. Neither multiple myeloma nor the classic (or pure) form of Waldenström's macroglobulinemia is marked by massive splenomegaly. Massive splenomegaly is rarely a feature of Hodgkin's disease.

Harvey E. Finkel, M.D.
92 Dean Rd., Brookline, MA 02445-4244

1 References

1
Case Records of the Massachusetts General Hospital (Case 27-2001). N Engl J Med 2001;345:682-687
Full Text | Web of Science | Medline

Author/Editor Response

The discussant replies:

To the Editor: I agree that Table 1 is somewhat misleading. It should have been entitled “Hematologic Diseases Associated with Splenomegaly and Anemia.” The causes of massive splenomegaly mentioned in the discussion include chronic myeloid leukemia, agnogenic myeloid metaplasia, and polycythemia vera. Variants of certain other hematologic cancers, such as chronic lymphocytic leukemia of the prolymphocytic type, and lymphoproliferative disorders, such as marginal-zone lymphoma, are other causes. Although splenomegaly has been described in multiple myeloma, Hodgkin's disease, and Waldenström's macroglobulinemia, these diseases certainly do not constitute the common causes of massive splenomegaly.

Noopur Raje, M.D.
Dana–Farber Cancer Institute, Boston, MA 02115

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