PDF(Pubmed)
Abstract：
This study describes an unusual case of multiple myeloma that progressed to anaplastic multiple myeloma in the pleural fluid. The Wright-stained cytospin of the pleural fluid showed a predominant population of mononuclear plasma cells with pleomorphic nuclei, characterized by both small and large nuclei, which is typical of anaplastic multiple myeloma. However, there were also more binuclear plasma cells with pleomorphic nuclei. Morphometric analysis showed that the mean nuclear length was 1.9-fold and 2.3-fold higher in the large nuclei compared to the small nuclei for the mononuclear plasma cells and binuclear plasma cells, respectively (p<0.001). The patient received B cell maturation antigen chimeric antigen receptor T cell (CAR-T) therapy for relapsed disease, with a significant reduction of the serum monoclonal paraprotein level at day 51 post-therapy. Pathologists should be aware that pleomorphic binuclear plasma cells can be part of the morphologic spectrum in anaplastic multiple myeloma.
摘要：
这项研究描述了一种罕见的多发性骨髓瘤病例，该病例在胸膜液中发展为间变性多发性骨髓瘤。胸膜液的赖特染色的细胞自旋显示，单核浆细胞的主要群体具有多形性核，以小核和大核为特征，这是典型的间变性多发性骨髓瘤。然而,也有更多的双核浆细胞具有多形核。形态分析表明，与单核浆细胞和双核浆细胞的小细胞核相比，大细胞核的平均细胞核长度分别高1.9倍和2.3倍，分别(p<0.001)。患者接受B细胞成熟抗原嵌合抗原受体T细胞（CAR-T）治疗复发性疾病，治疗后第51天血清单克隆副蛋白水平显着降低。病理学家应该意识到，多形性双核浆细胞可能是间变性多发性骨髓瘤形态谱的一部分。
