A case of multiple myeloma with markedly straight lines or curved deep groove nuclei

[摘要] A 62-year-old male presented to the hospital with spontaneousintracerebral hemorrhage. A full blood count showed a total leucocyte count of 5.54 × 109/L, hemoglobin concentration of 117 g/L, andplatelet count of 147 × 109/L. In bone marrow aspirate films, the proliferating plasma cells were predominantly observed, accounting for61.5% of the total nucleated cells. Strikingly, straight lines or curveddeep nuclear grooves were markedly noted in 28% of plasma cells(Figure 1, panels A–C; original magnification 1000×; Wright–Giemsastain). Laboratory evaluation revealed monoclonal M protein with theelevated IgA of 43.8 g/L. Abnormal monoclonal bands in IgA and κ laneswere found in immunofixation electrophoresis. Flow cytometry identified 1.54% of κ-restricted plasma cells expressing CD38, CD138, andCD56, which was also showed in bone marrow biopsy by immunohistochemistry. The skeletal examination by CT suggested multiple osteolytic bone destruction. Cytogenetic test showed a normal 46, XY karyotype. A diagnosis of multiple myeloma was made.