title: Non-secretory multiple myeloma with azurophilic granules and vacuoles: an immunological and ultrastructural study.
abstract: Cytoplasmic vacuolation was seen in patients with a variety of plasma cell dyscrasia. We report here a case of leukemic non-secretory multiple myeloma with many azurophilic granules. By electron microscopy, the myeloma cells were found to have a well-developed rough endoplasmic reticulum and a clear Golgi apparatus, and azurophilic granules were identified as phagocytic vacuoles. In addition to myeloma markers, the cells were positive for B cell-associated, myeloid and stem cell markers. The diagnosis is difficult because of its misleading morphology and unusual surface markers. We consider that electron microscopy is useful for the identification of cell lineage in this disorder.
authors.affiliation: Department of Internal Medicine, Toyonaka Municipal Hospital, Toyonaka, Osaka.
authors.forename: Jun
authors.initials: J
authors.lastname: Kuyama
authors.forename: Satoru
authors.initials: S
authors.lastname: Kosugi
authors.forename: Hironori
authors.initials: H
authors.lastname: Take
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Matsuyama
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kanayama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001854:Bone Marrow Cells / Q000473:pathology / Q000648:ultrastructure; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006056:Golgi Apparatus / Q000648:ultrastructure*; D006801:Humans; D007150:Immunohistochemistry; D008854:Microscopy, Electron / Q000379:methods; D009101:Multiple Myeloma / Q000473:pathology* / Q000648:ultrastructure*; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014617:Vacuoles / Q000648:ultrastructure