Non-secretory Multiple Myeloma with Azurophilic Granules and Vacuoles: An Immunological and Ultrastructural Study

• Published in: Internal Medicine Vol. 43; no. 7; pp. 590 - 594
• Main Authors: KUYAMA, Jun, KOSUGI, Satoru, TAKE, Hironori, MATSUYAMA, Tatsuo, KANAYAMA, Yoshio
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 01-07-2004; Japanese Society of Internal Medicine
• Subjects: Aged; Aged, 80 and over; azurophilic granules; Biological and medical sciences; Bone Marrow Cells - pathology; Bone Marrow Cells - ultrastructure; cytoplasmic vacuoles; Female; Flow Cytometry; Follow-Up Studies; General aspects; Golgi Apparatus - ultrastructure; Hematologic and hematopoietic diseases; Humans; Immunodeficiencies. Immunoglobulinopathies; Immunoglobulinopathies; Immunohistochemistry; Immunopathology; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Medical sciences; Microscopy, Electron - methods; Multiple Myeloma - pathology; Multiple Myeloma - ultrastructure; non-secretory myeloma; Risk Assessment; Sensitivity and Specificity; Severity of Illness Index; Vacuoles - ultrastructure; Immunopathology; azurophilic granules; cytoplasmic vacuoles; Malignant hemopathy; Myeloma; Vacuole; Medicine; Azurophil granule; Immunoglobulinopathy; Ultrastructure; Lymphoproliferative syndrome; Cytoplasm; non-secretory myeloma
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.43.590

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.