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Recurrent gastrointestinal bleeding in a patient with IgM paraproteinaemia
  1. Sanjay de Mel1,
  2. Muhammad Bilal Abid1,
  3. Kok-Siong Poon2,
  4. Sau-Yoke Ng2,
  5. Li-Mei Poon1,
  6. Shi Wang3
  1. 1Department of Haematology-Oncology, National University Cancer Institute Singapore, National University Health System, Singapore, Singapore
  2. 2Department of Laboratory Medicine, Molecular Diagnosis Centre, National University Health System, Singapore, Singapore
  3. 3Department of Pathology, National University Health System, Singapore, Singapore
  1. Correspondence to Dr Sanjay de Mel, Department of Haematology-Oncology, National University Cancer Institute, National University Health System, Singapore, Singapore; wspdm199{at}yahoo.com

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Clinical question

A 64-year-old man presented with gastrointestinal bleeding and inguinal lymphadenopathy. His lymph node biopsy is presented in slide A. An IgM paraprotein was detected in his serum while a full blood count and film suggested iron deficiency with no lymphocytosis. A small bowel mass was detected on CT scan but the patient declined further investigations including bone marrow studies. He was treated based on the lymph node histology with transient resolution of the bleeding. He subsequently underwent resection of the small bowel mass due to recurrent bleeding. The histology of the small bowel mass is presented in slide B.

Review the high-quality, interactive digital Aperio slide at http://virtualacp.com/JCPCases/jclinpath-2017-204415_A/ and http://virtualacp.com/JCPCases/jclinpath-2017-204415_B/ …

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