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Phagocytic, lambda light chain, plasma cell myeloma.

D P Wirt, T M Grogan, C M Payne

    American Journal of Clinical Pathology
    |July 1, 1983
    PubMed
    Summary
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    This study details a rare case of plasma cell myeloma with phagocytic activity, where myeloma cells consumed red blood cells, potentially causing anemia. This phagocytic myeloma exhibited a high proliferation rate, indicating a poor prognosis.

    Area of Science:

    • Hematology
    • Oncology
    • Immunology

    Background:

    • Plasma cell myeloma is a malignancy of plasma cells, typically characterized by monoclonal immunoglobulin production.
    • Phagocytosis, the engulfment of cells, is not a common feature of myeloma cells.

    Observation:

    • A 40-year-old male presented with anemia, enlarged spleen and liver, bone lesions, and lambda light chain monoclonal gammopathy.
    • Bone marrow examination revealed dysplastic plasma cells, with 10% exhibiting erythrophagocytosis (phagocytosis of red blood cells).
    • Electron microscopy confirmed myeloma cells containing erythroid cells within vacuoles.

    Findings:

    • Myeloma cells demonstrated specific cytochemical and immunophenotypic markers, confirming a monoclonal proliferation of differentiated plasma cells.

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  • Both phagocytic and non-phagocytic myeloma cells shared certain enzymatic and surface marker characteristics.
  • Immunofluorescence confirmed a monoclonal lambda light chain pattern in the myeloma cells, suggesting their neoplastic origin.

    • Implications:

    • This case highlights a rare variant of plasma cell myeloma with erythrophagocytic capability.
    • Erythrophagocytosis by myeloma cells may be a direct cause of hemolytic anemia in affected patients.
    • A high labeling index suggests aggressive tumor kinetics and a potentially poor prognosis, despite initial treatment response.