From www.bloodjournal.org by guest on September 11, 2016. For personal use only.
bloodwork ®
IMAGES
IN HEMATOLOGY
Orange-colored Russell bodies by Papanicolaou stain
c Irene Thung, University of California, San Diego; and Xiangdong Xu, VA San Diego Healthcare System
A
57-year-old man, treated 3 years earlier with chemotherapy and autologous bone marrow transplant for immunoglobulin A/l multiple myeloma, presented with right facial numbness, left lower extremity numbness, and a palpable right preauricular mass. Brain magnetic resonance imaging demonstrated multiple foci of intraparenchymal enhancements with possible leptomeningeal involvement, numerous bone metastases, and a mass superior to the right parotid gland. Cerebrospinal fluid slides were stained by a modified Romanowsky stain (panel A) and Papanicolaou stain (for cytology; panels Bi-ii) and revealed numerous anaplastic plasma cells characterized by abundant deeply basophilic cytoplasm, marked nuclear contour irregularity, and prominent nucleoli. Some cells contained variably sized, spherical cytoplasmic inclusions (Russell bodies), which appeared light blue using Romanowsky stain (panel A). Interestingly, the Russell bodies appeared orange when Papanicolaou stain was used (panels Bi-ii), which to our knowledge has not been reported previously. Flow cytometric analysis of cerebrospinal fluid demonstrated monoclonal plasma cells with an immunophenotype of CD45(1), CD38(1), cytoplasmic l(1), CD19(2), CD20(2), and CD56(2). The patient died 3 months later. For additional images, visit the ASH IMAGE BANK, a reference and teaching tool that is continually updated with new atlas and case study images. For more information visit http://imagebank.hematology.org. 1198
BLOOD, 12 FEBRUARY 2015 x VOLUME 125, NUMBER 7
From www.bloodjournal.org by guest on September 11, 2016. For personal use only.
2015 125: 1198 doi:10.1182/blood-2014-10-608638
Orange-colored Russell bodies by Papanicolaou stain Irene Thung and Xiangdong Xu
Updated information and services can be found at: http://www.bloodjournal.org/content/125/7/1198.full.html Articles on similar topics can be found in the following Blood collections BloodWork (465 articles) Free Research Articles (4041 articles) Lymphoid Neoplasia (2370 articles) Information about reproducing this article in parts or in its entirety may be found online at: http://www.bloodjournal.org/site/misc/rights.xhtml#repub_requests Information about ordering reprints may be found online at: http://www.bloodjournal.org/site/misc/rights.xhtml#reprints Information about subscriptions and ASH membership may be found online at: http://www.bloodjournal.org/site/subscriptions/index.xhtml
Blood (print ISSN 0006-4971, online ISSN 1528-0020), is published weekly by the American Society of Hematology, 2021 L St, NW, Suite 900, Washington DC 20036. Copyright 2011 by The American Society of Hematology; all rights reserved.
bloodwork ®
IMAGES
IN HEMATOLOGY
Orange-colored Russell bodies by Papanicolaou stain
c Irene Thung, University of California, San Diego; and Xiangdong Xu, VA San Diego Healthcare System
A
57-year-old man, treated 3 years earlier with chemotherapy and autologous bone marrow transplant for immunoglobulin A/l multiple myeloma, presented with right facial numbness, left lower extremity numbness, and a palpable right preauricular mass. Brain magnetic resonance imaging demonstrated multiple foci of intraparenchymal enhancements with possible leptomeningeal involvement, numerous bone metastases, and a mass superior to the right parotid gland. Cerebrospinal fluid slides were stained by a modified Romanowsky stain (panel A) and Papanicolaou stain (for cytology; panels Bi-ii) and revealed numerous anaplastic plasma cells characterized by abundant deeply basophilic cytoplasm, marked nuclear contour irregularity, and prominent nucleoli. Some cells contained variably sized, spherical cytoplasmic inclusions (Russell bodies), which appeared light blue using Romanowsky stain (panel A). Interestingly, the Russell bodies appeared orange when Papanicolaou stain was used (panels Bi-ii), which to our knowledge has not been reported previously. Flow cytometric analysis of cerebrospinal fluid demonstrated monoclonal plasma cells with an immunophenotype of CD45(1), CD38(1), cytoplasmic l(1), CD19(2), CD20(2), and CD56(2). The patient died 3 months later. For additional images, visit the ASH IMAGE BANK, a reference and teaching tool that is continually updated with new atlas and case study images. For more information visit http://imagebank.hematology.org. 1198
BLOOD, 12 FEBRUARY 2015 x VOLUME 125, NUMBER 7
From www.bloodjournal.org by guest on September 11, 2016. For personal use only.
2015 125: 1198 doi:10.1182/blood-2014-10-608638
Orange-colored Russell bodies by Papanicolaou stain Irene Thung and Xiangdong Xu
Updated information and services can be found at: http://www.bloodjournal.org/content/125/7/1198.full.html Articles on similar topics can be found in the following Blood collections BloodWork (465 articles) Free Research Articles (4041 articles) Lymphoid Neoplasia (2370 articles) Information about reproducing this article in parts or in its entirety may be found online at: http://www.bloodjournal.org/site/misc/rights.xhtml#repub_requests Information about ordering reprints may be found online at: http://www.bloodjournal.org/site/misc/rights.xhtml#reprints Information about subscriptions and ASH membership may be found online at: http://www.bloodjournal.org/site/subscriptions/index.xhtml
Blood (print ISSN 0006-4971, online ISSN 1528-0020), is published weekly by the American Society of Hematology, 2021 L St, NW, Suite 900, Washington DC 20036. Copyright 2011 by The American Society of Hematology; all rights reserved.
