**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Aaron Charles Lobo, Department of Internal Medicine, Bridgeport Hospital/Yale New Haven Health, Bridgeport, Connecticut

**Main Body of the Abstract**
IgM-associated light chain amyloidosis (AL) is an uncommon cause of systemic AL and a diagnosis of concurrent Waldenstrom’s Macroglobulinemia(WM) with AL is rare. We describe a 78-year-old male who was admitted with progressive mediastinal lymphadenopathy and left-sided pleural effusion. He initially underwent a mediastinoscopy with lymph node biopsy. Pathology was consistent with amyloidosis as confirmed on Congo-red staining. Further analysis with liquid chromatography in tandem with mass spectrometry for amyloid typing showed AL(lambda) subtype. Evaluation of his normocytic anemia with paraproteinemia studies showed two monoclonal bands (IgM kappa and IgA lambda) (Table 1). Initial flow cytometry of the lymph node, pleural fluid, bone marrow aspirate, and biopsy analysis were negative for clonal B-cell disease, but marrow cytogenetics were positive for MYD88(p.L265P). The patient continued to deteriorate clinically with progressive hypoxia and neutropenia. Reassessment of flowcytometry of pleural fluid was non-diagnostic. A repeat bone marrow biopsy showed lymphoplasmacytic infiltrates (plasma cells ~ 5-10% with slight lambda predominance) with cytogenetics and FISH showing: MYD88 + TET2 mutations and CCND1-IGH[translocation t(11;14)] gene rearrangement respectively, thus confirming the diagnosis of  lymphoplasmatic lymphoma(LPL)(Table 1). Given concern for autoimmune neutropenia high dose steroids were administered and WM directed therapy using bendamustine and rituximab was initiated. There is a paucity of data in literature to guide appropriate treatment of IgM-associated AL. Consideration of incorporating AL directed therapy with standard LPL treatment is warranted. This case also illustrates the predominance of pulmonary and nodal involvement in IgM-associated AL with LPL.



Pulmonary and nodal light chain amyloidosis as a presenting feature of Waldenstrom’s Macroglobulinemia: A case report PA82 (#486)

We invite you to attend the XIX International Symposium on Amyloidosis to be held in Rochester, MN.

This symposium is organized as a hybrid meeting (with the focus on in-person) held from Sunday, May 26 through Thursday, May 30, 2024.

Together with the ISA Board and members of Mayo Clinic, a very attractive scientific hybrid program is being planned. The program will cover a variety of types of systemic amyloidosis: ATTR (hereditary and wild-type), AL (light-chain), AA and less frequent forms. There will be key lectures, specific symposia including those company sponsored, oral presentations and poster sessions of accepted abstracts.

COURSE DESCRIPTION
This program will provide a comprehensive review of state-of-the-art education in systemic amyloidosis: basic science, pathophysiology, diagnosis, current and emerging treatments. Scientific presentations will include competitive oral and poster abstracts. The rapid evolution of scientific discovery and expanding treatment options has created tremendous interest in the field and this meeting will fill and important gap in educating scientists and clinicians.