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We report on a 36-year-old man who presented to the emergency department with haemoptysis. Computed tomography (CT) of the thorax showed a pulmonary mass paramediastinal in the right upper lobe, with the density of a haematoma. Laboratory data demonstrated an absolute lymphocytosis of 5.900 × 10/l (normal range, 1.150-3.250 × 10/l) and a prolonged activated partial thromboplastin time (APTT) of 47.7 s (normal range, 28.0-39.0 s). A de novo diagnosis of lymphoplasmacytic lymphoma (Waldenström macroglobulinaemia) was made, complicated by an acquired von Willebrand syndrome (aVWS) as demonstrated by further laboratory investigations. In this case report, we present a case of aVWS with markedly prolonged APTT and haemoptysis that revealed an underlying Waldenström macroglobulinaemia.

Clinical laboratories are responsible for the reference intervals reported on their laboratory reports, as specified by the International Organization for Standardization standard 15 189. Although required by the directive on in vitro diagnostic medical devices in the European Union (98/79/EC), manufacturers' information about the reference intervals is often very limited, is frequently based on pre-Additional supporting information may be found online in the Supporting Information section.

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