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Razavi HM: Spherical bodies in MGUSTurk J Hematol 2021;38:151-152A 78-year-old male patient with mild cytopenias (hemoglobin120 g/L with platelet count of 114x10 9 /L) and low lambda clonalparaprotein (6.9 g/L) is described. A bone marrow biopsy showedthe presence of trilinear hematopoiesis with occasional plasmacells (<10%). A trephine biopsy showed the presence of largespherical bodies (Figure 1A, black arrows), which were provednot to be cell-free by CD138/kappa/lambda stains, existing asinclusions in lambda-restricted plasma cells (Figures 1B-1D).With <10% clonal plasmacytosis, lack of end organ damage,and paraprotein at <30 g/L, monoclonal gammopathy ofundetermined significance was diagnosed. Plasma cell inclusionswere first described by Russell in 1890 [1]. Inclusions in thecytoplasm (Russell bodies) and overlaying the nucleus (Dutcherbodies) usually leave the cellular morphology intact. H&Emorphology and immunohistochemistry in this case showedcomplete cellular effacement with cytoplasmic ballooning. Avariety of intracytoplasmic inclusions have been reported andinclude mulberry-type inclusions in Mott cells, vermillion-tingeddeposits in immunoglobulin A-type flame cells, and even Auerrod-like inclusions [2]. The nature of the inclusions has beenelucidated as amalgamation of condensed immunoglobulins indilated vesicles associated with ER cisternae. The significance oftheir presence in disease progression is unknown.Keywords: Monoclonal gammopathy of undeterminedsignificance, Plasma cell inclusions, Russell bodies,ImmunohistochemistryAnahtar Sözcükler: Önemi belirlenemeyen monoklonalgammopati, Plazma hücre inklüzyonları, Russell cisimsikleri,İmmünohistokimyaFinancial Disclosure: The author declared that this studyreceived no financial support.References1. Russell W. An address on characteristic organism of cancer. Br Med J1890;2:1356-1360.2. Metzgeroth G, Back W, Maywald O, Schatz M, Willer A, Hehlmann R, HastkaJ. Auer rod-like inclusions in multiple myeloma. Ann Hematol 2003;82:57-60.152
Sall A. et al: Flower-Like Plasma Cell Nuclei in Multiple MyelomaIMAGES IN HEMATOLOGYDOI: 10.4274/tjh.galenos.2020.2020.0471Turk J Hematol 2021;38:153-154Flower-Like Plasma Cell Nuclei in Multiple MyelomaMultipl Myelomda Çiçek Benzeri Plazma Hücre NukleusuAbibatou Sall 1 , Moussa Seck 2 , Diama Samb 1 , Blaise Faye 1 , Macoura Gadji 1 , Saliou Diop 1 , Awa Oumar Touré 1,31Dalal Jamm Hospital, Laboratory of Hematology, Dakar, Senegal2Cheikh Anta Diop University-Hematology, Hematology Clinic Department, Dakar, Senegal3Aristide Le Dantec Hospital-Laboratory of Hematology Pasteur Avenue, Dakar, SenegalFigure 1. A) Plasma cells with dysmorphic nuclei. B) Flower-like nuclei (red arrow) and rouleaux (light bluecircle). C, E) Flower-like nuclei. D) Mitotic event (blue arrow). Lymphoplasmacytic cells (black arrows). Redarrow: plasma cell with a prominent nucleolus. F) Monoclonal gamma globulin peak on protein electrophoresis.G, H) Flow cytometry showing CD38/138+, CD45 weak , and CD56+.©Copyright 2021 by Turkish Society of HematologyTurkish Journal of Hematology, Published by Galenos Publishing HouseAddress for Correspondence/Yazışma Adresi: Abibatou Sall, M.D., Dalal Jamm Hospital,Clinic of Hematology, Dakar, SenegalE-mail : sallabibatou@gmail.com ORCID: orcid.org/0000-0001-5685-4417Received/Geliş tarihi: August 12, 2020Accepted/Kabul tarihi: September 28, 2020153
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