RESUMO
Waldenstrom macroglobulinemia (WM) is a rare lymphoproliferative disease that can have an ambiguous clinical presentation. A key component of the pathophysiology of WM is bone marrow infiltration, which most commonly presents as anemia. Other symptoms of WM tend to be generalized and non-specific, which presents a diagnostic challenge. This was the case with our patient as well, when he presented to our outpatient clinic with non-specific symptoms. We present a 79-year-old male with longstanding pancytopenia, polyarthralgia, bilateral pedal edema, decreased appetite, and increased bleeding from wounds. The patient had a complete blood count (CBC) and complete metabolic panel (CMP) done, confirming present anemia, which prompted inpatient treatment and an oncology workup, confirming WM. The patient began a zanubrutinib monotherapy regimen, showing improvement in his pancytopenia, polyarthralgia, and overall symptoms.
RESUMO
The appendix is a vermiform-like organ that extends from the cecum and has been thought of as having a rudimentary immunologic function. However, the appendix can become distended and mucus-filled, classifying it as a mucocele appendix. Mucoceles can be found in various locations in the body, including the colon and the appendix, and have malignancy potential. We report a case of a 48-year-old male that presented to the ED with a history of two days of abdominal pain. Upon arriving at the ED, he had a CT scan showing a 9.5 x 4.2 x 6.4 cm fluid collection in the right lower quadrant (RLQ) juxtaposed to the cecum, suggesting appendicitis or an abscess. Initially, a laparoscopic approach was taken, which was then converted to an open laparotomy. The mass was excised and a right hemicolectomy was performed along with an ileocolonic anastomosis due to extensive involvement of the large intestine. Pathology reported a low-grade appendiceal mucinous neoplasm resected with negative margins and 16 negative lymph nodes.