A presumptive diagnosis of W.M. was considered in a patient with the
usual clinical, cytological, and histological features of this disease. However,
neither a monoclonal serum Ig nor free p. chains could be demonstrated in
serum or urine. 1gM K molecules were found in the cytoplasm of 13% of
the bone marrow cells including lymphocytes and 3% typical plasma cells,
some of which showed positive intranuclear inclusions and some a morular
cell pattern. In the surface immunofluorescence experiments, 57% of the
blood lymphocytes were brightly stained by antisera to p. and K chains. These
data suggest a “nonsecretory macroglobulinemia.”
It should be emphasized that, as in .CLL, very few lymphocytes carrying
other Ig specificities than those of the monoclonal S.Ig were found in these
conditions with bone marrow pleomorphic lymphoid proliferation.