case_images: PMC5684595_01
case_images: Peripheral blood smears from (a) Case 1 and (b) Case 2, which exhibit rouleaux formation of the red blood cells.
case_images: CRIHEM2017-3732902.001.jpg
case_images: PMC5684595_02_CRIHEM2017-3732902.001.jpg
case_images: fig1
case_images: A peripheral blood smear clearly exhibited rouleaux formation (Figure 1).
case_images: Immunostaining of lymphoplasmacytic lymphoma (LPL) cells in the bone marrow clot preparation from Case 1. The LPL cells were diffusely positive for CD20 but only sporadically positive for CD38 (original magnification, x400).
case_images: CRIHEM2017-3732902.002.jpg
case_images: PMC5684595_01_CRIHEM2017-3732902.002.jpg
case_images: fig2
case_images: As shown in Figure 2, the bone marrow was infiltrated with LPL cells that were diffusely positive for CD20 but only sporadically positive for CD38.
case_images: Fundoscopic findings. (a) Case 1 exhibited bilateral central retinal vein occlusion (CRVO) and optic nerve head edema with diffuse peripheral and central retinal hemorrhages that were accompanied by a large vitreous hemorrhage. (b) Case 2 exhibited bilateral tortuous blood vessels with a rod-like retinal hemorrhage (left eye) without macular edema.
case_images: CRIHEM2017-3732902.003.jpg
case_images: PMC5684595_02_CRIHEM2017-3732902.003.jpg
case_images: fig3
case_images: Although the patient did not complain of vision problems, fundoscopy revealed bilateral tortuous blood vessels with a few hemorrhages but no macular edema (Figure 3).
case_images: PMC5684595_02
case_images: Peripheral blood smears from (a) Case 1 and (b) Case 2, which exhibit rouleaux formation of the red blood cells.
case_images: CRIHEM2017-3732902.001.jpg
case_images: PMC5684595_02_CRIHEM2017-3732902.001.jpg
case_images: fig1
case_images: A peripheral blood smear clearly exhibited rouleaux formation (Figure 1).
case_images: Fundoscopic findings. (a) Case 1 exhibited bilateral central retinal vein occlusion (CRVO) and optic nerve head edema with diffuse peripheral and central retinal hemorrhages that were accompanied by a large vitreous hemorrhage. (b) Case 2 exhibited bilateral tortuous blood vessels with a rod-like retinal hemorrhage (left eye) without macular edema.
case_images: CRIHEM2017-3732902.003.jpg
case_images: PMC5684595_02_CRIHEM2017-3732902.003.jpg
case_images: fig3
case_images: Although the patient did not complain of vision problems, fundoscopy revealed bilateral tortuous blood vessels with a few hemorrhages but no macular edema (Figure 3).
case_images: Histopathology findings of the biopsied tissue of the right kidney of Case 2. (a) Light microscopy revealed tubulointerstitial nephritis with marked infiltration by lymphoplasmacytic lymphoma (LPL) cells that were diffusely positive for CD20 (G: glomerulus; T: tubules; original magnification, x100). (b) Electron microscopy showed that the renal tissue was infiltrated by LPL cells (original magnification, x1,000). (c) Fluorescence microscopy revealed dot-like IgM depositions in the mesangial region (there were no depositions for IgG, IgA, or C3c). Significant morphological glomerular changes were not noted (photos not shown).
case_images: CRIHEM2017-3732902.004.jpg
case_images: PMC5684595_02_CRIHEM2017-3732902.004.jpg
case_images: fig4
case_images: Light and electron microscopic studies of the biopsied kidney tissue revealed massive interstitial LPL cell infiltration, while the fluorescence microscopic study revealed mild dot-like mesangial IgM depositions (Figure 4).