intracellular and extracellular rhomboid shaped crystalline inclusions in a case of igg lambda restricted plasma cell myeloma a case report and review of the literature细胞内和细胞外的菱形晶体中夹杂物的免疫球蛋白gλ限制浆细胞骨髓瘤病例报告和文献之回顾.pdfVIP

Matoso et al. Diagnostic Pathology 2010, 5:6 /content/5/1/6 CASE REPORT Open Access Intracellular and extracellular rhomboid shaped crystalline inclusions in a case of IgG lambda restricted plasma cell myeloma: a case report and review of the literature Andres Matoso1,3, Tina Rizack2,3, Diana O Treaba1,3* Abstract The presence of crystalline inclusions in plasma cell myeloma is a rare phenomenon and cases have been reported with rod, needle, and rectangular shaped crystals. Here, we present a case of IgG lambda restricted plasma cell myeloma with rhomboid shaped intracellular crystalline inclusions and extracellular crystal depositions in the bone marrow. Since rhomboid crystal depositions can be seen in other clinical conditions such as pseudogout, this case invites consideration of plasma cell myeloma in the differential diagnosis of patients with rhomboid crystalline deposition in the bone marrow and in sites/organs other than the bone marrow. Background Case Presentation Plasma cell myeloma accounts for approximately one The patient is a 72 year-old male who was referred to a percent of all cancers and slightly more than 10 percent hematologist for work-up of anemia and leukopenia. He of hematologic malignancies in the United States [1]. has had a gradual and persistent decrease in his hemo- The disease stems from malignant transformation of globin levels during the past 3 years (13.6 G/DL in aver- plasma cells with frequent overproduction of immuno- age; reference values 13.5-16.0 G/DL) associated with globulins. Its clinical presentation with intracellular and mild leukopenia (3.4 × 103/μL; reference values 3.5-11.0 extracellular crystalline inclusions is