Page 209 - Clinical Hematology Atlas

CHAPTER 19 MATURE LYMPHOPROLIFERATIVE DISORDERS 193

E F
FIGURE 19–4E Proplasmacyte (PB 31000). The FIGURE 19–4F Flame cell (BM 31000).
cytoplasm is darker blue and the perinuclear hof Associated with plasma cells that are producing
is distinct. The nucleus is eccentric and the IgA.
nucleolus is partially masked by the clumped
chromatin.

MORPHOLOGY
Peripheral Blood: Rouleaux, rare circulating plasma
cell; 6 neutropenia
NOTE: .2 3 10 /L circulating plasma cells suggest
9
plasma cell leukemia.
6 Normocytic, normochromic anemia
6 Thrombocytopenia

NOTE: The background of Wright-stained blood
smears may be blue because of abnormal
amounts of immunoglobulin.
Bone Marrow: .10% plasma cells, often .30%
Immature 6 larger than normal plasma cell
with increased N/C ratio; abnormal nuclear
chromatin; 6 nucleoli, 6 multinucleated
Cytoplasm pale blue or dark; cytoplasm may
contain immunoglobulin inclusions G
FIGURE 19–4G Mott cell (Morula cell, grape cell)
IMMUNOPHENOTYPE
CD19 , CD38 , CD138 1 (BM 31000). Plasma cell containing multiple
1
2
NOTE: This disease may be distinguished from round globules of immunoglobulin, which stain
Waldenström macroglobulinemia and heavy chain pink, colorless, or blue.
disease by immunoelectrophoresis.