[IgG-kappa type multiple myeloma with cytoplasmic crystalline inclusions].
An 82-year-old male was admitted to our hospital because of anemia with Hb 6.9/dl. The serum monoclonal IgG of the kappa type was detected. Bone marrow aspiration showed the presence of 38.9% atypical plasma cells with crystalline inclusions. These crystalline inclusions were stained with acid phosphatase, and remained unstained with MPO, PAS and Congo-Red staining. Immunofluorescence studies showed the plasma cells were positive for IgG-kappa type immunoglobulin and CD138. Electron microscopy revealed varying numbers of stick-like, rod-shaped, rhomboid or rectangular crystals of a variety of lengths and sizes with a periodicity giving an appearance of longitudinal striation. The inclusions were most often surrounded by ribosomes. Some crystalline inclusions were located in the rough-surfaced endoplasmic reticulum. Their presence was probably due to an abnormality in the synthesis and/or secretion of immunoglobulin.
Kobayashi
Chiharu
C
Department of Clinical Laboratory, Fujieda Municipal General Hospital.
Tanabe
Juichi
J
Aoki
Mayako
M
Suzuuki
Rieko
R
Asai
Hiroaki
H
Kurita
Masashi
M
Murata
Takashi
T
Mohri
Hiroshi
H
D000369:Aged, 80 and over; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis*; D007145:Immunoglobulin kappa-Chains / Q000032:analysis*; D002479:Inclusion Bodies / Q000000981:diagnostic imaging*; D008297:Male; D009101:Multiple Myeloma / Q000276:immunology* / Q000648:ultrastructure*; D014463:Ultrasonography
D007074:Immunoglobulin G; D007145:Immunoglobulin kappa-Chains