Pathologies of Renal and Systemic Intracellular Paraprotein Storage: Crystalopathies and Beyond

  • Maria M. PickenEmail author
  • Ahmet Dogan
Part of the Current Clinical Pathology book series (CCPATH)


This chapter provides a brief overview of pathologies associated with intracellular paraproteins, both renal and systemic. The expanding spectrum of intracellular immunoglobulin storage pathologies, including both organized deposits (crystalline, rarely fibrillar) and non-organized deposits, is considered. In the kidney, earlier observations reported an association between Fanconi syndrome and the presence of prominent, kappa light chain restricted crystals in proximal tubular epithelium. However, more recent observations have included also noncrystalline light chain proximal tubulopathy, which may be more prevalent than the crystalline type and tends to be associated predominantly with lambda light chain restriction. To encompass this expanding spectrum of proximal tubular pathology, the term light chain proximal tubulopathy was proposed. In crystal-storing histiocytosis, the histiocytes contain prominent intralysosomal crystalline cytoplasmic immunoglobulin inclusions. However, more recently, noncrystallized forms of immunoglobulin-storing histiocytosis have also been recognized and the term immunoglobulin-storing histiocytosis has been proposed to encompass the expanding pathology. In certain plasma cell dyscrasias/B-cell lymphoproliferative disorders, similar crystalline and noncrystalline inclusions can also be seen in the neoplastic plasma/B-cells. Although the lesions discussed in this chapter are relatively rare, awareness of these lesions is important since they represent a useful indicator that can facilitate the early diagnosis of an underlying plasma cell dyscrasia/B-cell lymphoproliferative process and avoid misdiagnosis. While, in many instances, the clinical course may be indolent, significant target organ damage occurs over time. Although there is no consensus with regard to the best treatment options, elimination of the involved clone is associated with a reversal of target organ injury. Therefore, efforts to design effective treatments for these “small but dangerous” clones should continue.


Fanconi syndrome Light chain proximal tubulopathy Crystal-storing histiocytosis Immunoglobulin-storing histiocytosis 


  1. 1.
    Picken MM. Monoclonal gammopathies: glomerular and tubular injuries. In: McManus LM, Mitchell RN, editors. Pathobiology of human disease. A dynamic encyclopedia of disease mechanisms. Oxford: Elsevier; 2014.Google Scholar
  2. 2.
    Herrera GA, Picken MM. Renal diseases associated with plasma cell dyscrasias, Waldenstrom macroglobulinemia and cryoglobulinemic nephropathies. In: Jennette JC, Olson JL, Schwartz MM, Silva FG, editors. Heptinstall’s pathology of the kidney. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2014. p. 951–1014.Google Scholar
  3. 3.
    Dogan S, Barnes L, Cruz-Vetrano WP. Crystal-storing histiocytosis: report of a case, review of the literature (80 cases) and a proposed classification. Head Neck Pathol. 2012;6(1):111–20. Epub 2012 Mar 20.PubMedCentralCrossRefPubMedGoogle Scholar
  4. 4.
    Gupta V, El Ters M, Kashani K, Leung N, Nasr SH. Crystalglobulin-induced nephropathy. J Am Soc Nephrol. 2015;26(3):525–9. doi: 10.1681/ASN.2014050509. Epub 2014 Sep 4.
  5. 5.
    Sicard A, Karras A, Goujon JM, Sirac C, Bender S, Labatut D, Callard P, Sarkozy C, Essig M, Vanhille P, Provot F, Nony A, Nochy D, Ronco P, Bridoux F, Touchard G. Light chain deposition disease without glomerular proteinuria: a diagnostic challenge for the nephrologist. Nephrol Dial Transplant. 2014;29(10):1894–902. Epub 2014 Mar 11.CrossRefPubMedGoogle Scholar
  6. 6.
    Sirota JH, Hamerman D. Renal function studies in an adult subject with the Fanconi syndrome. Am J Med. 1954;16:138.CrossRefPubMedGoogle Scholar
  7. 7.
    Maldonado JE, Velosa JA, Kyle RA, et al. Fanconi syndrome in adults. A manifestation of a latent form of myeloma. Am J Med. 1975;58:354.CrossRefPubMedGoogle Scholar
  8. 8.
    Aucouturier P, Bauwens M, Khamlichi AA, et al. Monoclonal Ig L chain and L chain V domain fragment crystallization in myeloma-associated Fanconi’s syndrome. J Immunol. 1993;150:3561.PubMedGoogle Scholar
  9. 9.
    Sirac C, Bridoux F, Carrion C, et al. Role of the monoclonal kappa chain V domain and reversibility of renal damage in a transgenic model of acquired Fanconi syndrome. Blood. 2006;108:536.CrossRefPubMedGoogle Scholar
  10. 10.
    Messiaen T, Deret S, Mougenot B, et al. Adult Fanconi syndrome secondary to light chain gammopathy: clinicopathologic heterogeneity and unusual features in 11 patients. Medicine. 2000;79:135.CrossRefPubMedGoogle Scholar
  11. 11.
    Kapur U, Barton K, Fresco R, Leehey DJ, Picken MM. Expanding the pathologic spectrum of immunoglobulin light chain proximal tubulopathy. Arch Pathol Lab Med. 2007;131(9):1368–72.PubMedGoogle Scholar
  12. 12.
    Lebeau A, Zeindl-Eberhart E, Muller EC, Muller-Hocker J, Jungblut PR, Emmerich B, Lohrs U. Generalized crystal-storing histiocytosis associated with monoclonal gammopathy: molecular analysis of a disorder with rapid clinical course and review of the literature. Blood. 2002;200(5):1817–27.Google Scholar
  13. 13.
    Stokes MB, Aronoff B, Siegel D, D’Agati VD. Dysproteinemia-related nephropathy associated with crystal-storing histiocytosis. Kidney Int. 2006;70:597–602.CrossRefPubMedGoogle Scholar
  14. 14.
    El Hamel C, Thierry A, Trouillas P, Bridoux F, Carrion C, Quellard N, Goujon JM, Aldigier JC, Gombert JM, Cogne M, Touchard G. Crystal-storing histiocytosis with renal Fanconi syndrome: pathological and molecular characteristics compared with classical myeloma-associated Fanconi syndrome. Nephrol Dial Transplant. 2010;25:2982.CrossRefPubMedGoogle Scholar
  15. 15.
    Toly-Ndour C, Peltier J, Piedagnel R, Coppo P, Sachon E, Ronco P, Rondeau E, Callard P, Aucouturier P. Acute renal failure with lambda light chain-derived crystals in a patient with IgD myeloma. Nephrol Dial Transplant 2011;26(9):3057–9. doi: 10.1093/ndt/gfr377. Epub 2011 Jul 7.
  16. 16.
    El Hamel C, Aldigier JC, Oblet C, Laffleur B, Bridoux F, Cogné M. Specific impairment of proximal tubular cell proliferation by a monoclonal κ light chain responsible for Fanconi syndrome. Nephrol Dial Transplant. 2012;27(12):4368–77. doi: 10.1093/ndt/gfs261. Epub 2012 Sep 28.CrossRefPubMedGoogle Scholar
  17. 17.
    Sirac C, Bridoux F, Essig M, Devuyst O, Touchard G, Cogné M. Toward understanding renal Fanconi syndrome: step by step advances through experimental models. Contrib Nephrol. 2011;169:247–61. Epub 2011 Jan 20.CrossRefPubMedGoogle Scholar
  18. 18.
    Elliott MR, Cortese C, Moreno-Aspitia A, Dwyer JP. Plasma cell dyscrasia causing light chain tubulopathy without Fanconi syndrome. Am J Kid Diseases. 2010;55(6):1136–41.CrossRefGoogle Scholar
  19. 19.
    Sanders PW. Mechanisms of light chain injury along the tubular nephron. J Am Soc Nephrol. 2012;23:1777–81. doi: 10.1681/ASN.2012040388.CrossRefPubMedGoogle Scholar
  20. 20.
    Larsen CP, Bell JM, Harris AA, Messias NC, Wang YH, Walker PD. The morphologic spectrum and clinical significance of light chain proximal tubulopathy with and without crystal formation. Mod Pathol. 2011;24(11):1462–9. doi: 10.1038/modpathol.2011.104. Epub 2011 Jun 24.
  21. 21.
    Sharma SG, Bonsib SM, Portilla D, Shukla A, Woodruff AB, Gokden N. Light chain proximal tubulopathy: expanding the pathologic spectrum with and without deposition of crystalline inclusions. ISRN Pathol. 2012;2012:1–6; Article ID 541075, 6 pp., doi: 10.5402/2012/541075.Google Scholar
  22. 22.
    Rane S, Rana S, Sachdeva M, Joshi K. Light chain proximal tubulopathy without crystals in a case of burkitt lymphoma presenting with acute kidney injury. Am J Kid Diseases. 2013;62(3):638–41.CrossRefGoogle Scholar
  23. 23.
    Herrera GA. Proximal tubulopathies associated with monoclonal light chains: the spectrum of clinicopathologic manifestations and molecular pathogenesis. Arch Pathol Lab Med. 2014;138(10):1365–80.CrossRefPubMedGoogle Scholar
  24. 24.
    Deret S, Denoroy L, Lamarine M, et al. Kappa light chain-associated Fanconi’s syndrome: molecular analysis of monoclonal immunoglobulin light chains from patients with and without intracellular crystals. Protein Eng. 1999;12:363.CrossRefPubMedGoogle Scholar
  25. 25.
    Bridoux F, Sirac C, Hugue V, et al. Fanconi’s syndrome induced by a monoclonal Vkappa3 light chain in Waldenstrom’s macroglobulinemia. Am J Kidney Dis. 2005;45:749–57.CrossRefPubMedGoogle Scholar
  26. 26.
    Lajoie G, Leung R, Bargman JM. Clinical, biochemical, and pathological features in a patient with plasma cell dyscrasia and Fanconi’s syndrome. Ultrastruct Pathol. 2000;24:221–6.CrossRefPubMedGoogle Scholar
  27. 27.
    Decourt C, Bridoux F, Touchard G, et al. A monoclonal V kappa l light chain responsible for incomplete proximal tubulopathy. Am J Kidney Dis. 2003;41:497.CrossRefPubMedGoogle Scholar
  28. 28.
    Gu X, Barrios R, Cartwright J, et al. Light chain crystal deposition as a manifestation of plasma cell dyscrasias: the role of immunoelectron microscopy. Hum Pathol. 2003;34:270–7.CrossRefPubMedGoogle Scholar
  29. 29.
    Cai G, Sidhu GS, Wieczorek R, et al. Plasma cell dyscrasia with kappa light- chain crystals in proximal tubular cells: a histological, immunofluorescent, and ultrastructural study. Ultrastruct Pathol. 2006;30:315–9.CrossRefPubMedGoogle Scholar
  30. 30.
    Thorner PS, Bedard YC, Fernandes BJ. Lambda-light-chain nephropathy with Fanconi’s syndrome. Arch Pathol Lab Med. 1983;107:654–7.PubMedGoogle Scholar
  31. 31.
    Noguchi K, Munemura C, Maeda S, et al. Myeloma-associated Fanconi syndrome due to λ-light chain crystal deposition. Yonago Acta Medica. 2004;47:91–6.Google Scholar
  32. 32.
    Ma CX, Lacy MQ, Rompala JF, et al. Acquired Fanconi syndrome is an indolent disorder in the absence of overt multiple myeloma. Blood. 2004;104:40.CrossRefPubMedGoogle Scholar
  33. 33.
    Herlitz LC, Roglieri J, Resta R, Bhagat G, Markowitz GS. Light chain proximal tubulopathy. Kidney Int. 2009;76:792–7.CrossRefPubMedGoogle Scholar
  34. 34.
    Figueres M, Beaume J, Vuiblet V, Rabant M, Bassilios N, Herody M, Touchard G, Noël LH. Crystalline light chain proximal tubulopathy with chronic renal failure and silicone gel breast implants: 1 case report. Hum Path. 2015;46(1):165–8. Published Online: October 24, 2014.CrossRefPubMedGoogle Scholar
  35. 35.
    Sethi S, Cuiffo BP, Pinkus GS, Rennke HG. Crystal-storing histiocytosis involving the kidney in a low-grade B-cell lymphoproliferative disorder. Am J Kidney Dis. 2002;39(1):183–8.CrossRefPubMedGoogle Scholar
  36. 36.
    Tomika M, Ueki K, Nakahashi A, et al. Widespread crystalline inclusions affecting podocytes, tubular cells and interstitial histiocytes in the myeloma kidney. Clin Nephrol. 2003;62:229–33.CrossRefGoogle Scholar
  37. 37.
    Akilesh S, Alem A, Nicosia RF. Combined crystalline podocytopathy and tubulopathy associated with multiple myeloma. Hum Pathol. 2014;45(4):875–9. Epub 2013 Oct 19.CrossRefPubMedGoogle Scholar
  38. 38.
    Watanabe H, Osawa Y, Goto S, Habuka M, Imai N, Ito Y, Hirose T, Chou T, Ohashi R, Shimizu A, Ehara T, Shimotori T, Narita I. A case of endocapillary proliferative glomerulonephritis with macrophages phagocytosing monoclonal immunoglobulin lambda light chain. Pathol Int. 2015;65(1):38–42. doi: 10.1111/pin.12229. Epub 2014 Nov 19.
  39. 39.
    Duquesne A, Werbrouck A, Fabiani B, Denoyer A, Cervera P, Verpont MC, Bender S, Piedagnel R, Brocheriou I, Ronco P, Boffa JJ, Aucouturier P, Garderet L. Complete remission of monoclonal gammopathy with ocular and periorbital crystal storing histiocytosis and Fanconi syndrome. Hum Pathol. 2013;44(5):927–33. Epub 2013 Jan 11.CrossRefPubMedGoogle Scholar
  40. 40.
    Taneda S, Honda K, Horita S, et al. Proximal tubule cytoplasmic fibrillary inclusions following kidney transplantation in a patient with a paraproteinemia. Am J Kid Dis. 2009;53:715–8.CrossRefPubMedGoogle Scholar
  41. 41.
    Yao Y, Wang S-X, Zhang Y-K, Wang Y, Liu L, Liu G. Acquired Fanconi syndrome with proximal tubular cytoplasmic fibrillary inclusions of λ light chain restriction. Intern Med. 2014;53:121–4.CrossRefPubMedGoogle Scholar
  42. 42.
    Corbett RW, Cook HT, Duncan N, Moss J. Fibrillary inclusions in light chain proximal tubulopathy associated with myeloma. Clin Kidney J. 2012;5(1):75–6.PubMedCentralCrossRefPubMedGoogle Scholar
  43. 43.
    Larsen CP, Borrelli GS, Walker PD. Amyloid proximal tubulopathy: a novel form of light chain proximal tubulopathy. Clin Kidney J. 2012;5(2):130–2.CrossRefGoogle Scholar
  44. 44.
    Hemminger J, Satoskar A, Brodsky SV, Calomeni E, Nadasdy GM, Kovach P, Hofmeister CC, Nadasdy T. Unique pattern of renal κ light chain amyloid deposition with histiocytic transdifferentiation of tubular epithelial cells. Am J Surg Pathol. 2012;36(8):1253–7.CrossRefPubMedGoogle Scholar
  45. 45.
    Merlini G, Stone MJ. Dangerous small clones. Blood. 2006;108:2520–30.CrossRefPubMedGoogle Scholar
  46. 46.
    Fermand JP, Bridoux F, Kyle RA, Kastritis E, Weiss BM, Cook MA, Drayson MT, Dispenzieri A, Leung N. International kidney and Monoclonal Gammopathy Research Group. How i treat Monoclonal Gammopathy of Renal Significance (MGRS). Blood. 2013;122(22):3583–90. Epub 2013 Oct 9.CrossRefPubMedGoogle Scholar
  47. 47.
    Jones D, Bhatia VK, Krausz T, Pinkus GS. Crystal storing histiocytosis: a disorder occurring in plasmacytic tumors expressing immunoglobulin kappa light chain. Hum Pathol. 1999;30(12):1441–8.CrossRefPubMedGoogle Scholar
  48. 48.
    Sun Y, Tawfiqul B, Valderrama E, Kline G, Kahn LB. Pulmonary crystal-storing histiocytosis and extranodal marginal zone B-cell lymphoma associated with a fibroleiomyomatous hamartoma. Ann Diagn Pathol. 2003;7(1):47–53.CrossRefPubMedGoogle Scholar
  49. 49.
    Galed-Placed I. Immunoglobulin crystal-storing histiocytosis in a pleural effusion from a woman with IgA κ multiple myeloma. Acta Cytol. 2006;50:539–41.CrossRefPubMedGoogle Scholar
  50. 50.
    Pock L, Stuchlik D, Hercegova J. Crystal storing histiocytosis of the skin associated with multiple myeloma. Int J Dermatol. 2006;45(12):1408–11.CrossRefPubMedGoogle Scholar
  51. 51.
    Chantranuwat C. Noncrystallized form of immunoglobulin-storing histiocytosis as a cause of chronic lung infiltration in multiple myeloma. Ann Diagn Pathol. 2007;11(3):220–2.CrossRefPubMedGoogle Scholar
  52. 52.
    Kusakabe T, Watanabe K, Mori T, Iida T, Suzuki T. Crystal-storing histiocytosis associated with MALT lymphoma of the ocular adnexa: a case report with review of literature. Virchows Arch. 2007;450(1):103–8. Epub 2006 Nov 17.CrossRefPubMedGoogle Scholar
  53. 53.
    de Alba Campomanes AG, Rutar T, Crawford JB, Seiff S, Goodman D, Grenert J. Crystal-storing histiocytosis and crystalline keratopathy caused by monoclonal gammopathy of undetermined significance. Cornea. 2009;28(9):1081–4.CrossRefPubMedGoogle Scholar
  54. 54.
    Sailey CJ, Alexiev BA, Gammie JS, Pinell-Salles P, Stafford JL, Burke A. Crystal-storing histiocytosis as a cause of symptomatic cardiac mass. Arch Pathol Lab Med. 2009;133:1861–4.PubMedGoogle Scholar
  55. 55.
    Kurabayashi A, Iguchi M, Matsumoto M, Hiroi M, Kume M, Furihata M. Thymic mucosa-associated lymphoid tissue lymphoma with immunoglobulin-storing histiocytosis in Sjögren’s syndrome. Pathol Int. 2010;60(2):125–30.CrossRefPubMedGoogle Scholar
  56. 56.
    Bosman C, Camassei FD, Boldrini R, Piro FR, Saponara M, Romeo R, Corsi A. Solitary crystal-storing histiocytosis of the tongue in a patient with rheumatoid arthritis and polyclonal hypergammaglobulinemia. Arch Pathol Lab Med. 1998;122:920–4.PubMedGoogle Scholar
  57. 57.
    Lee WS, Kim SR, Moon H, Choe YH, Park SJ, Lee HB, Jin GY, Chung MJ, Lee YC. Pulmonary crystal-storing histiocytoma in a patient without a lymphoproliferative disorder. Am J Med Sci. 2009;338(5):421–4.CrossRefPubMedGoogle Scholar
  58. 58.
    Khurram SA, McPhadden A, Hislop WS, Hunter KD. Crystal storing histiocytosis of the tongue as the initial presentation of multiple myeloma. Oral Surg Oral Med Oral Pathol Oral Radiol Endocrinol. 2011;111(4):494–6.CrossRefGoogle Scholar
  59. 59.
    Gao FF, Khalbuss WE, Austin RM, Monaco SE. Cytomorphology of crystal storing histiocytosis in the breast associated with lymphoma: a case report. Acta Cytol. 2011;55(3):302–6. Epub 2011 Apr 27.CrossRefPubMedGoogle Scholar
  60. 60.
    Kaminsky IA, Wang AM, Olsen J, Schechter S, Wilson J, Olson R. Central nervous system crystal-storing histiocytosis: neuroimaging, neuropathology, and literature review. AJNR. 2011;32:E26–8.CrossRefPubMedGoogle Scholar
  61. 61.
    Li Z, Li P, Wang Z, Huang G. Primary extranodal soft-tissue B-cell lymphoma with abundant immunoglobulin inclusions mimicking adult rhabdomyoma: a case report. J Med Case Rep. 2011;5:53. Scholar
  62. 62.
    Ko HM, da Cunha Santos G, Boerner SL, Bailey DJ, Geddie WR. Negative images of crystalline immunoglobulin in crystal storing histiocytosis: A potential cytologic mimic of mycobacteria in smears. Diagn Cytopathol. 2012;40(10):916–9. doi: 10.1002/dc.21677. Epub 2011 May 4.
  63. 63.
    Saluja K, Thakral B, Goldschmidt RA. Crystal storing histiocytosis associated with marginal zone B-cell lymphoma: a rare initial clinical presentation diagnosed by fine-needle aspiration. Cytojournal. 2014;11:17. Published online Jun 12, 2014.PubMedCentralCrossRefPubMedGoogle Scholar
  64. 64.
    Tsuji T, Yamasaki H, Hirano T, Toyozumi Y, Arima N, Tsuda H. Crystal-storing histiocytosis complicating marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue. Int J Hematol. 2014;100(6):519–20. Epub 2014 Sep 13.CrossRefPubMedGoogle Scholar
  65. 65.
    Vaid A, Caradine KD, Lai KK, Rego R. Isolated gastric crystal-storing histiocytosis: a rare marker of occult lymphoproliferative disorders. J Clin Pathol. 2014;67(8):740–1. Epub 2014 May 9.CrossRefPubMedGoogle Scholar
  66. 66.
    Tahara K, Miyajima K, Ono M, Sugio Y, Yamamoto I, Tamiya S. Crystal-storing histiocytosis associated with marginal-zone lymphoma. Jpn J Radiol. 2014;32(5):296–301. Epub 2014 Mar 16.CrossRefPubMedGoogle Scholar
  67. 67.
    Li JJ, Henderson C. Cutaneous crystal storing histiocytosis: a report of two cases. J Cutan Pathol. 2015;42(2):136–43. doi: 10.1111/cup.12413. Epub 2014 Nov 24.
  68. 68.
    Chaudhary S, Navarro M, Laser J, Berman E, Bhuiya T. Localized crystal-storing histiocytosis presenting as a breast nodule: an unusual presentation of a rare entity. Breast J. 2014;20(5):539–42. Epub 2014 Jul 17.CrossRefPubMedGoogle Scholar
  69. 69.
    Kai K, Miyahara M, Tokuda Y, Kido S, Masuda M, Takase Y, Tokunaga O. A case of mucosa-associated lymphoid tissue lymphoma of the gastrointestinal tract showing extensive plasma cell differentiation with prominent Russell bodies. World J Clin Cases. 2013;1(5):176–80.PubMedCentralCrossRefPubMedGoogle Scholar
  70. 70.
    Johnson M, Mazariegos J, Lewis PJ, Pomakova D. Crystal storing histiocytosis presenting as a temporal lobe mass lesion. Surg Neurol Int. 2013;4:112.PubMedCentralCrossRefPubMedGoogle Scholar
  71. 71.
    Rossi G, De Rosa N, Cavazza A, Mengoli MC, Della Casa G, Nannini N, Colby TV. Localized pleuropulmonary crystal-storing histiocytosis: 5 cases of a rare histiocytic disorder with variable clinicoradiologic features. Am J Surg Pathol. 2013;37(6):906–12.CrossRefPubMedGoogle Scholar
  72. 72.
    da Cruz Perez DE, Silva-Sousa YT, de Andrade BA, Rizo VH, Almeida LY, León JE, de Almeida OP. Crystal-storing histiocytosis: a rare lesion in periapical pathology. Ann Diagn Pathol. 2012;16(6):527–31. Epub 2011 Aug 16.CrossRefPubMedGoogle Scholar
  73. 73.
    Rossi G, Morandi U, Nannini N, Fontana G, Pifferi M, Casali C. Crystal-storing histiocytosis presenting with pleural disease. Histopathology. 2010;56(3):403–5.CrossRefPubMedGoogle Scholar
  74. 74.
    Todd WU, Drabick JJ, Benninghoff MG, Frauenhoffer EE, Zander DS. Pulmonary crystal-storing histiocytosis diagnosed by computed tomography-guided fine-needle aspiration. Diagn Cytopathol. 2010;38(4):274–8.PubMedGoogle Scholar
  75. 75.
    Orr BA, Gallia GL, Dogan A, Rodriguez FJ. IgA/kappa-restricted crystal storing histiocytosis involving the central nervous system characterized by proteomic analysis. Clin Neuropathol. 2014;33(1):23–8.PubMedCentralCrossRefPubMedGoogle Scholar
  76. 76.
    Lv Y, Liu Y, Li X, Yan Q, Wang Z. Plasmacytoma with crystal-storing histiocytosis exhibiting FGFR3 and IgH translocation. Pathology. 2015;47(1):82–5. doi: 10.1097/PAT.0000000000000200.
  77. 77.
    Rodriguez FJ, Gamez JD, Vrana JA, Theis JD, Giannini C, Scheithauer BW, Parisi JE, Lucchinetti CF, Pendlebury WW, Bergen 3rd HR, Dogan A. Immunoglobulin derived depositions in the nervous system: novel mass spectrometry application for protein characterization in formalin-fixed tissues. Lab Invest. 2008;88(10):1024–37. Epub 2008 Aug 18.CrossRefPubMedGoogle Scholar
  78. 78.
    Shamanna RK, Xu-Monette ZY, Miranda RN, Zou D, Weber D, Dogan A, O’Malley DP, Bueso-Ramos C, Orlowski RZ, Medeiros LJ, Young KH. Clinicopathologic and molecular features of crystal (immunoglobulin) storing histiocytosis associated with lymphoplasmacytic neoplasms. Histopathology 2015, in press.Google Scholar
  79. 79.
    Magnano L, Fernández de Larrea C, Cibeira MT, Rozman M, Tovar N, Rovira M, Rosiñol L, Bladé J. Acquired Fanconi syndrome secondary to monoclonal gammopathies. Clin Lymphoma Myeloma Leuk. 2013;13(5):614–8. Epub 2013 Jun 15.CrossRefPubMedGoogle Scholar
  80. 80.
    Thakral B, Courville E. Crystal-storing histiocytosis with IgD–κ associated plasma cell neoplasm. Blood. 2014;123:3540.CrossRefPubMedGoogle Scholar
  81. 81.
    Lesesve JF, Bronowicki JP, Galed-Placed I. Crystal-storing histiocytosis in ascites from a patient with IgM kappa lymphoplasmacytic lymphoma. Cytopathology. 2011;22(3):207–8. Epub 2010 Nov 9.CrossRefPubMedGoogle Scholar
  82. 82.
    Miura TE, Takihi IY, Maekawa YH, Chauffaille Mde L, Rizzatti EG, Sandes AF. Iron staining in gammopathy-related crystal-storing histiocytosis: a misleading feature to the differential diagnosis with Gaucher’s disease. Mol Genet Metab. 2013;110(3):414–5. Epub 2013 Aug 8.CrossRefPubMedGoogle Scholar
  83. 83.
    Chan JK. The wonderful colors of the hematoxylin-eosin stain in diagnostic surgical pathology. Int J Surg Pathol. 2014;22(1):12–32. Epub 2014 Jan 9.CrossRefPubMedGoogle Scholar
  84. 84.
    Kawano N, Beppu K, Oyama M, Himeji D, Yoshida S, Kuriyama T, Ono N, Masuyama H, Yamashita K, Yamaguchi K, Shimao Y, Oshima K, Ueda Y, Ueda A. Successful surgical treatment for pulmonary crystal-storing histiocytosis following the onset of gastric non-hodgkin lymphoma. J Clin Exp Hematop. 2013;53(3):241–5.CrossRefPubMedGoogle Scholar
  85. 85.
    Hu X, Liu J, Bai C, Wang J, Song X. Bortezomib combined with thalidomide and dexamethasone is effective for patient with crystal-storing histiocytosis associated with monoclonal gammopathy of undermined significance. Eur J Haematol. 2012;89(2):183–4. Epub 2012 Jun 7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Department of PathologyLoyola University Medical Center, Loyola University ChicagoMaywoodUSA
  2. 2.Departments of Pathology and Laboratory MedicineMemorial Sloan Kettering Cancer CenterNew YorkUSA

Personalised recommendations