Noncrystallized form of immunoglobulin-storing histiocytosis as a cause of chronic lung infiltration in multiple myeloma.
A 52-year-old man, with a known case of multiple myeloma, developed chronic bilateral pulmonary infiltration. Open lung biopsy displayed desquamated interstitial pneumonia-like pattern characterized by diffused patchy intra-alveolar accumulation of unusual macrophages containing abundant round intracytoplasmic eosinophilic globular structures 1-7 microm in size. The globules were stained positively with restriction for kappa light chain by immunoperoxidase study. Electron microscopic examination revealed amorphous substances without a crystalline shape or fine ultrastructure of lattice or linear parallel configuration, indicating storage of noncrystallized immunoglobulin. The current report documented, for the first time, the noncrystallized form of immunoglobulin-storing histiocytosis, causing an unusual pulmonary pathology in a patient with multiple myeloma.
Chantranuwat
Chavit
C
Department of Pathology, Faculty of Medicine, Chulalongkorn University Hospital, Bangkok 10330, Thailand. chavit_ch@hotmail.com
D003460:Crystallization; D015614:Histiocytosis / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007136:Immunoglobulins / Q000378:metabolism*; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000473:pathology*; D008264:Macrophages / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000473:pathology*
D007136:Immunoglobulins