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LETTER TO EDITOR Table of Contents   
Year : 2008  |  Volume : 51  |  Issue : 4  |  Page : 562-563
Unusual sighting: Amyloid deposits in bone marrow aspirate in multiple myeloma


1 Laboratory Oncology, Institute Rotary Cancer Hospital, AIIMS, New Delhi, India
2 Medical Oncology, Institute Rotary Cancer Hospital, AIIMS, New Delhi, India

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How to cite this article:
Chopra A, Anand M, Kumar R, Kalita D, Raina V. Unusual sighting: Amyloid deposits in bone marrow aspirate in multiple myeloma. Indian J Pathol Microbiol 2008;51:562-3

How to cite this URL:
Chopra A, Anand M, Kumar R, Kalita D, Raina V. Unusual sighting: Amyloid deposits in bone marrow aspirate in multiple myeloma. Indian J Pathol Microbiol [serial online] 2008 [cited 2020 Feb 23];51:562-3. Available from: http://www.ijpmonline.org/text.asp?2008/51/4/562/43764


Sir,

Bone marrow (BM) plasmacytosis is seen in primary amyloidosis with or without co-existing multiple myeloma (MM). The plasmacytosis in the former condition is generally less than 10% whereas it exceeds 20% when amyloidosis complicates multiple myeloma. [1]

Our patient with MM with amyloidosis showed nucleolated plasma cells studded in amyloid completely replacing the BM biopsy [Figure 1]. The patient, a 75-year-old woman, presented with low back pain. A skeletal survey showed bilateral lytic lesions in her femur, pelvis, ribs, and skull. A dense, 5.7 g/dl IgG kappa M-band was seen in the mid-gamma region on serum electrophoresis. More interestingly, and the reason for this communication, was the very unusual finding, rarely illustrated, [2] of extensive amyloid deposits even in the bone marrow aspirate [Figure 2a],[Figure 2b],[Figure 2c]. These appeared as pink-purple, fluffy, amorphous masses generally with entrapped nucleolated, often degenerating plasma cells.

Amyloid deposits are rarely seen or recognized on bone marrow touch imprints and aspirates. Textbooks generally do not mention their occurrence. They are therefore, liable to be missed. Recognition of this beautiful and striking finding, pink or purple fluffy masses, reminiscent somewhat of that children's delight, candy floss, is of interest not only in its own right, but also because this makes possible a rapid diagnosis of amyloidosis co-existing with myeloma, particularly when only a bone marrow aspiration has been done[1],[2]

 
   References Top

1.Greipp PR, Leong T, Bennett JM, Gaillard JP, Klein B, Stewart JA, et al. Plasmablastic morphology--an independent prognostic factor with clinical and laboratory correlates: Eastern Cooperative Oncology Group (ECOG) myeloma trial E9486 report by the ECOG Myeloma Laboratory Group. Blood 1998:91:2501-7.  Back to cited text no. 1    
2.Brunning RD, McKenna RW. Tumors of the bone marrow. Washington DC: Armed Forces Institute of Pathology; 1994. p. 360-3.  Back to cited text no. 2    

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Correspondence Address:
Mona Anand
Laboratory Oncology, IRCH AIIMS, Ansari Nagar, New Delhi 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0377-4929.43764

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    Figures

  [Figure 1], [Figure 2a], [Figure 2b], [Figure 2c]

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[Pubmed] | [DOI]



 

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