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IMAGE IN HEMATOLOGY
Year : 2017  |  Volume : 8  |  Issue : 4  |  Page : 160

Histiocytoid plasma cells in multiple myeloma


Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Date of Web Publication12-Jan-2018

Correspondence Address:
Dr. Shano Naseem
Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joah.joah_49_17

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How to cite this article:
Sharma P, Naseem S. Histiocytoid plasma cells in multiple myeloma. J Appl Hematol 2017;8:160

How to cite this URL:
Sharma P, Naseem S. Histiocytoid plasma cells in multiple myeloma. J Appl Hematol [serial online] 2017 [cited 2019 Sep 18];8:160. Available from: http://www.jahjournal.org/text.asp?2017/8/4/160/223179



A 45-year-old female presented to the hematology clinic for evaluation of chronic anemia. She was found to have hemoglobin of 8 g/dL, total leukocyte count of 2.2 × 109/μL, and a platelet count of 123 × 106/μL. Serum protein electrophoresis revealed an M band (3.08 g/dl) which was found to be of IgA-kappa type on immunofixation electrophoresis. X-ray skull showed lytic lesions, and the serum calcium, urea, and creatinine levels were 7.2 mg/dl, 41 mg/dl, and 0.58 mg/dl, respectively. Bone marrow aspirate identified 82% cells with histiocytoid appearance having central to peripherally placed round tiny nucleus and abundant foamy, crumpled papery cytoplasm [Figure 1]a. Bone marrow trephine biopsy was replaced with sheets of histiocytoid cells having pseudo-Gaucher cell-like appearance [Figure 1]b. Immunohistochemistry for CD138 and CD68 was performed, which highlighted a strong membranous positivity for CD138 in all of these cells [Figure 1]c and [Figure 1]d.
Figure 1: (a): Bone marrow aspirate smears showing histiocytoid cells having slightly eccentrically placed nucleus and foamy cytoplasm (May-Grunwald Giemsa stain, ×400). (b) Bone marrow trephine biopsy showing large histiocytoid cells with abundant eosinophilic cytoplasm (H and E, ×200). (c) Immunohistochemistry for CD138 showing strong membranous positivity in these cells (immunoperoxidase stain, ×200). (d) Immunohistochemistry showing absence of CD68 expression in these cells (immunoperoxidase stain, ×200)

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Pseudo-Gaucher cell-like plasma cells are rarely reported and are potential mimickers of storage disorder. Pseudo-Gaucher cells can be seen in various disorders such as Hodgkin's lymphoma, thalassemia, and chronic myeloid leukemia including multiple myeloma; however, plasma cells itself showing the pseudo-Gaucher cell type morphology is an intriguing phenomenon.[1],[2]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Shenjere P, Roy A, Eyden B, Banerjee SS. Pseudo-gaucher cells in multiple myeloma. Int J Surg Pathol 2008;16:176-9.  Back to cited text no. 1
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2.
Saroha V, Gupta P, Singh M, Singh T. Pseudogaucher cells obscuring multiple myeloma: A case report. Cases J 2009;2:9147.  Back to cited text no. 2
[PUBMED]    


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