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Interstitial and diffuse infiltration by a plasma cell neoplasia and nodular bone marrow infiltration by small lymphocytic lymphoma (SLL).
Bone Marrow
Haematoxylin & Eosin (H&E)
82 years
Anemia. Suspicion of IgG-kappa Plasmocytoma. Lymphocytosis.
Hypercellular bone marrow with an irregularily distributed megakaryopoesis without cytologic atypia. Partial displacement of the erythropoesis. Partial maturational disruption of the myelopoesis. Nodular infiltration by a small cell lymphocytic proliferation and diffuse, interstitial infiltration by an asynchronous plasma cell proliferation (which can be appreciated in the Giemsa stain).
CD38 and MUM1 confirm the infiltration by plasma cells. The immunohistochemical double staining for kappa (brown) and lambda (red) light chains shows a kappa light chain restriction with single lambda positive cell as an internal positive control. The lymphoid infiltration is also weakly positive for MUM1, but shows a strong expression of CD5, CD20 and CD23 leading to the diagnosis of small lymphocytic B-cell lymphoma (B-CLL).
Manuel Schlageter, University of Basel
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