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[Vacuolar inclusions with multivesicular structure in leukemic multiple myeloma].
1Third Department of Internal Medicine, Kyoto First Red Cross Hospital.
Summary
This case study reports on leukemic multiple myeloma with unusual plasma cell vacuolar inclusions. The findings suggest a significant role for the lysosomal system in vacuolation.
Area of Science:
- Hematology
- Oncology
- Cell Biology
Background:
- Leukemic multiple myeloma is a rare plasma cell malignancy.
- Understanding cellular morphology is crucial for diagnosis and prognosis.
Observation:
- A 67-year-old male presented with bone pain and was diagnosed with IgG-lambda multiple myeloma.
- Peripheral blood and bone marrow revealed significant plasmacytosis (63% and 90% respectively).
- Plasma cells exhibited large, unique vacuolar inclusions in the cytoplasm.
Findings:
- Vacuolar inclusions were PAS and myeloperoxidase negative.
- Acid phosphatase staining showed dense activity around and sparse granules within vacuoles.
- Ultrastructural analysis revealed membrane-bound cytoplasmic spaces with microvesicles and occasional fibrillary structures.
Implications:
- The lysosomal system is implicated in the vacuolation observed in these myeloma plasma cells.
- This unique morphology may offer insights into myeloma pathogenesis.
- Further research into lysosomal function in myeloma is warranted.