Blut

, Volume 36, Issue 3, pp 149–157 | Cite as

Ultrastructural features of the plasma cells in “non-secretory” myeloma

  • S. Weiss
  • U. H. Lewinski
  • A. J. Pick
  • U. Gafter
  • M. Djaldetti
Original Papers

Summary

A case of “non-secretory” multiple myeloma is described. The diagnosis was based on the clinical picture, typical radiological findings, and infiltration of the bone marrow by myeloma cells which showed specific immuno-fluorescence staining mainly with antisera for IgM and kappa light chains. An attempt is made to explain the absence of pathological proteins in the serum, based on the ultrastructural findings of the myeloma cells, which showed “buddings” of the cell membranes containing endoplasmic reticulum and cytoplasmic material. It is suggested that the cells of the “non-secretory” type of multiple myeloma possess a normal excretory mechanism, but the pathological proteins are prevented to be secreted in the serum being surrounded by portions of the cell membrane.

Key words

Plasma cells Non-secretory myeloma Electron microscopy 

Zusammenfassung

Bei einem Patienten mit nichtsekretorischem Plasmozytom wurden die Plasmazellen immunologisch und elektronenmikroskopisch untersucht. Die Diagnose beruhte auf dem klinischen Bild, den typischen Röntgenbefunden und einer Infiltration des Knochenmarks durch Plasmozytomzellen, die eine spezifische Immunfiuoreszenz mit Antiseren für IgM und kappa-Leichtketten zeigten. Es wird versucht, das Fehlen des Paraproteins im Serum mit Hilfe der elektronenmikroskopischen VerÄnderungen zu erklÄren. In den Plasmazellen der nichtsekretorischen Myelome wird die Sekretion der Paraproteine wahrscheinlich dadurch verhindert, da\ sie durch Membranfragmente eingeschlossen werden.

Schlüsselwörter

Plasmazellen Nichtsekretorisches Myelom Elektronenmikroskopie 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Arend, W.P., Adamson, J.W.: Nonsecretory myeloma. Immunofluorescent demonstration of paraprotein within bone marrow plasma cells. Cancer33, 721–728 (1974)Google Scholar
  2. 2.
    Azar, H.A., Zaino, E.C., Duc Pham, T., Yannopoulos, K.: “Nonsecretory” plasma cell myeloma: observations on seven cases with electron microscopic studies. Am. J. Clin. Pathol.58, 618–629 (1972)Google Scholar
  3. 3.
    Bessis, M.: Ultrastructure of normal and leukemic granulocytes. In: Proceedings of the International Conference on Leukemia-Lymphoma, pp. 281–303. Philadelphia: Lea & Febiger 1968Google Scholar
  4. 4.
    Carbone, P.P., Kellerhouse, L.E., Gehan, E.A.: Plasmacytic myeloma. A study of the relationship of survival to various clinical manifestations and anomalous protein type in 112 patients. Am. J. Med.42, 937–948 (1967)Google Scholar
  5. 5.
    Di Guglielmo, R.: Unusual morphologic and humoral conditions in the field of plasma-cytomas and M-dysproteinemia. Acta Med. Scand.79, Suppl. 445, 206–211 (1966)Google Scholar
  6. 6.
    Djaldetti, M., Bessler, H., Fishman, P., Lewinski, U., Mandel, M.: Ultrastructural features of the white blood cells in the leukemias. Harefuah83, 528–535 (1972)Google Scholar
  7. 7.
    Foa, R., Perrimond, H., Orsini, A., Muratore, R.: Etude cytochimique et ultrastructurale d'une observation de leucose aÏgue à cellules monocytoides. C.R. Soc. Biol. (Paris)164, 593–597 (1970)Google Scholar
  8. 8.
    Gach, J., Simar, L., Salmon, J.: Multiple myeloma without M-type proteinemia. Report of a case with immunologic and ultrastructure studies. Am. J. Med.50, 835–844 (1971)Google Scholar
  9. 9.
    Hobbs, J.R.: Immunochemical classes of myelomatosis. Including data from a therapeutic trial conducted by a Medical Research Council Working Party. Br. J. Haematol.16, 599–606 (1969)Google Scholar
  10. 10.
    Hurez, D., Preud'Homme, J.-L., Seligmann, M.: Intracellular “monoclonal” immunoglo-bulin in non-secretory human myeloma. J. Immunol.104, 263–264 (1970)Google Scholar
  11. 11.
    Indiveri, F., Barabino, A., Santolini, M.E., Santolini, B.: “Nonsecretory” multiple myeloma. Report of a case. Acta Haematol.51, 302–309 (1974)Google Scholar
  12. 12.
    Lough, J., Shuster, J.: Constipated plasma cells associated with monomeric macroglobuline-mia. Hum. Pathol.6, 251–255 (1975)Google Scholar
  13. 13.
    Maldonado, J.E., Brown, A.L. Jr., Bayrd, E.D., Pease, G.L.: Ultrastructure of the myeloma cell. Cancer19, 1613–1627 (1966)Google Scholar
  14. 14.
    Mason, D.Y., Farrell, C., Taylor, C.R.: The detection of intracellular antigens in human leucocytes by immunoperoxidase staining. Br. J. Haematol.31, 361–370 (1975)Google Scholar
  15. 15.
    Osserman, E.F., Takatsuki, K.: Plasma cell myeloma: gamma globulin synthesis and structure. A review of biochemical and clinical data with the description of a newly-recognized and related syndrome, “Hγ−2-chain (Franklin's) disease”. Medicine (Baltimore)42, 357–384 (1963)Google Scholar
  16. 16.
    Osserman, E.F., Fahey, J.L.: Plasma cell dyscrasias. Current clinical and biochemical concepts. Am. J. Med.44, 256–269 (1968)Google Scholar
  17. 17.
    Preud'Homme, J.-L., Hurez, D., Danon, F., Brouet, J.C., Seligmann, M.: Intracytoplasmic and surface-bound immunoglobulins in “nonsecretory” and Bence-Jones myeloma. Clin. Exp. Immunol.25, 428–436 (1976)Google Scholar
  18. 18.
    Rausing, A.: Lymphatic leukemia and malignant lymphoma in the adult. Acta Med. Scand.199, Suppl. 595, 60 (1976)Google Scholar
  19. 19.
    River, G.L., Tewksbury, D.A., Fudenberg, H.H.: “Non-secretory” multiple myeloma. Blood40, 204–206 (1972)Google Scholar
  20. 20.
    Stavem, P., Froland, S.S., Haugen, H.F., Lislerud, A.: Nonsecretory myelomatosis without intracellular immunoglobulin. Immunofluorescent and ultramicroscopic studies. Scand. J. Haematol.17, 89–95 (1976)Google Scholar
  21. 21.
    Taylor, C.R.: Hodgkin's disease and the lymphomas, p. 100. Montreal: Eden Press 1976Google Scholar
  22. 22.
    Whicher, J.T., Davies, J.D., Grayburn, J.A.: Intact and fragmented intracellular immunoglobulin in a case of non-secretory myeloma. J. Clin. Pathol.28, 54–59 (1975)Google Scholar

Copyright information

© Springer-Verlag 1978

Authors and Affiliations

  • S. Weiss
    • 1
    • 2
    • 3
  • U. H. Lewinski
    • 1
    • 2
    • 3
  • A. J. Pick
    • 1
    • 2
    • 3
  • U. Gafter
    • 1
    • 2
    • 3
  • M. Djaldetti
    • 1
    • 2
    • 3
  1. 1.Department of Internal Medicine “B” and Electron Microscopy UnitHasharon HospitalPetah-Tiqva
  2. 2.Clinical Immunology Section, Rogoff-Wellcome Research InstituteBeilinson HospitalPetah-Tiqva
  3. 3.Tel Aviv University Medical SchoolIsrael

Personalised recommendations