A 72-year-old man presents with severe headaches, blurry vision, and spontaneous epistaxis. Vital signs show BP 168/94 mmHg, HR 88/min, RR 16/min, temp 37°C. Fundoscopy reveals dilated tortuous retinal veins. Serum studies demonstrate markedly elevated IgM at 8.2 g/dL with normal hemoglobin. Bone marrow biopsy shows lymphoplasmacytic infiltration. He denies recent infections or lymphadenopathy. Which diagnosis best explains these findings?

  1. A)Waldenstrom macroglobulinemiaGABARITO
  2. B)Follicular lymphoma
  3. C)Essential thrombocythemia
  4. D)Multiple myeloma
  5. E)Acute lymphoblastic leukemia

Explicação

Waldenstrom macroglobulinemia is the correct answer because excess IgM increases serum viscosity, producing headaches, visual changes, and mucosal bleeding. Ver explicação completa e trilha adaptativa →

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