case_images: PMC5768267_01
case_images: (a) Right eye swelling, (b) resolution of eye swelling after 2 months of chemotherapy, and (c) MRI of head and neck showing T2 hyperintensities in the calvarium.
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case_images: Physical examination included diffuse right eyelid edema and right frontal tenderness (Figure 1(a)). However, a magnetic resonance imaging (MRI) of the brain showed hyperintense foci in the right frontal calvarium leading to the eye swelling (Figure 1(b)).
case_images: Bone marrow biopsy stained with hematoxylin and eosin showing a solid proliferation of mature appearing plasma cells. Left: objective 200x; right: objective 400x.
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case_images: Bone marrow biopsy demonstrated a hypercellular marrow comprised at least 70% mature appearing plasma cells staining positive for CD138 (Figures 2 and 3).
case_images: Bone marrow biopsy immunohistochemical stain CD138 used to highlight plasma cells. Objective 400x.
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case_images: Bone marrow biopsy demonstrated a hypercellular marrow comprised at least 70% mature appearing plasma cells staining positive for CD138 (Figures 2 and 3).
case_images: Flow cytometry showing plasma cells isolated with CD38 and CD138 antigens. They are kappa clonal and express CD56. Both markers indicate a malignancy.
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case_images: There is no evidence of increased blasts (Figure 4).
case_images: Fluorescence in situ hybridization (FISH) test was performed using dual color, dual fusion probes to detect the translocation between the CCND1 gene located at 11q (orange probe) and the IGH@ gene located at 14q (green probe). Signal that has joined orange and green color confirms presence of translocation (11;14)(q13.3;q32.3).
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case_images: Fluorescence in situ hybridization (FISH) test was positive for IGH@ gene rearrangement involving 14q32.3, CCND1/IGH@ gene for translocation (11;14)(q13.3;q32.3), and deletion 13q (RB1) (Figure 5).