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Related Experiment Videos

Bone marrow extracellular large geometric crystals in IgG/lambda MGUS.

Gaia Goteri1, Paola Lorenzini, Manrico Morroni

  • 1Institute of Pathology, University of Ancona, Azienda Ospedaliera Torrette, Italy.

Pathology, Research and Practice
|June 7, 2002
PubMed
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Pathologists identified unusual eosinophilic crystals in bone marrow biopsies from a patient with immunoglobulin G lambda monoclonal gammopathy of undetermined significance (MGUS). These paraprotein-related crystals may indicate broader organ involvement.

Area of Science:

  • Hematopathology
  • Immunopathology

Background:

  • Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant condition characterized by the presence of a monoclonal immunoglobulin in the serum or urine.
  • Bone marrow histopathology is crucial for diagnosing and monitoring MGUS and related plasma cell disorders.

Observation:

  • A unique case of IgG lambda MGUS revealed striking eosinophilic crystals within the bone marrow interstitium.
  • These crystals exhibited specific shapes (rectangular, rhomboid, square) and did not provoke a foreign body giant cell reaction.
  • The crystals were absent in bone marrow aspirate smears, suggesting artifactual formation during tissue processing.

Findings:

  • Histochemical, immunoreactivity, and ultrastructural analyses confirmed the crystals were composed of the patient's lambda light chain paraprotein.

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  • The crystalline deposits differed morphologically and histochemically from amyloid and other proteinaceous materials seen in plasma cell proliferations.

    • Implications:

    • Awareness of these paraprotein crystals is important for accurate bone marrow histopathology interpretation.
    • Their detection may warrant further investigation for immunoglobulin deposition in other organs.