Osteolytic gamma heavy chain disease

We report a case of gamma heavy chain disease (GHCD) with several unique features: extensive osteolytic lesions simulating advanced multiple myeloma (MM), skin involvement, under the age of 40 yr, and the appearance of a series of pathological cells with indented or lobulated nuclei. The most remarkable feature is a previously unreported extensive bone destruction. Except for the presence of this bone disease, the clinical and pathological features of the patient resembled those of GHCD rather than those of MM. We have reviewed 3 previously reported cases of GHCD associated with skeletal involvement and compared these with our case.