Osseous Manifestations of Waldenström's Macroglobulinemia

Bone involvement in Waldenström's macroglobulinemia is not as unusual as previously believed. Roentgenographic examinations of 41 patients with Waldenström's macroglobulinemia were reviewed, and 19.5% of these patients were found to have destructive bone lesions. Extensive generalized demineralization was present in 7. The radiographic appearance was indistinguishable from that of multiple myeloma or other malignant lesions of the lymphoproliferative system. The differential diagnosis must be based on serum protein analysis rather than radiographic findings or cellular morphology. Unusual symmetrical, cyst-like lesions in the supra-acetabular portions of the iliac bones were noted in 3 patients.