Open AccessMULTIPLE MYELOMA, IgA x TYPE, ACCOMPANYING CRYSTAL‐STORING HISTIOCYTOSIS AND AMYLOIDOSIS
Author(s) -
Takahashi Kiyoshi,
Naito Makoto,
Takatsuki Kiyoshi,
Kono Fumio,
Chitose Masami,
Ooshima Shuichi,
Mori Naoyoshi,
Sakuma Hideo,
Uchino Fumiya
Publication year - 1987
Publication title -
acta patholigica japonica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
ISSN - 0001-6632
DOI - 10.1111/j.1440-1827.1987.tb03142.x
Subject(s) - pathology , spleen , amyloidosis , multiple myeloma , acid phosphatase , antibody , chemistry , immunoelectron microscopy , myeloma protein , cytoplasm , immunohistochemistry , biology , medicine , enzyme , immunology , biochemistry
An autopsy case of multiple myeloma, IgA x type, accompanying systemic crystal‐storing histiocytosis and generalized amyloidosis, is reported. Besides multiple destructive lesions in the skeletal bones, nodular myeloma cell infiltrates were scattered in the liver, spleen, and both kidneys. Not only in these lesions but also in the reticuloendothelial organs, crystal‐storing macro‐phages appeared dispersively or in clusters. Electron microscopically, numerous crystalline inclusions contained in the cytoplasm of macrophages were membrane‐bound and of variable configuration, comprising of a homogeneous electron‐lucid material. Enzyme cytochemically, almost all of the inclusions showed acid phosphatase activity. On the basis of the results obtained from the immunohistochemical, immunofluorescent and immunoelectron microscopic studies, it was considered that the crystalline inclusions stored in the macrophages were derived from IgA x immunoglobulin secreted from the myeloma cells and were formed within secondary lysosomes by crystallization during lysosomal digestion and degradation of the ingested immunoglobulin by macrophages. Generalized amyloidosis developed in different sites from those of the crystal‐storing histiocytosis and were proven immunohisto‐chemically to belong to AL amyloidosis probably derived from a certain group of A x precursor protein.