Abstract
RATIONALE: Automated serum index is widely used in biochemical testing, enabling the observation of sample characteristics to a certain extent. The differences between serum lipemia index and sample characteristics can, to a certain extent, facilitate early detection of certain diseases. PATIENT CONCERNS: This is a case report of an elderly patient who was admitted to cardiology outpatient clinic due to dizziness. DIAGNOSES: Basic tests were normal, but hidden lab tests found abnormal serum index. After discussion, further tests showed high immunoglobulin levels. INTERVENTIONS: We performed a lymph node color Doppler ultrasound, blood light chain determination, blood immunization fixed electrophoresis, and urine immunofixation electrophoresis detection. Flow cytometry (lymphoma), FISH (MM + IGH) and MYD88 were detected. OUTCOMES: Consequently, the patient was advised to be transferred to the hematology department and was ultimately diagnosed with Lymphoplasmacytic Lymphoma/Waldenström Macroglobulinemia. LESSONS: This case was facilitated by the early detection of discrepancies between lipemia indices and sample appearance despite normal examination results. Additionally, close collaboration between clinical laboratory technicians and clinicians facilitated the uncovering of subtle early disease changes, thereby aiding in precise diagnoses.