case_images: PMC2782213_01
case_images: Bone marrow biopsy (A) and lymph node biopsy (B) specimens. BM biopsy revealed normocellular marrow with multifocal increase of plasma cells. Lymph node biopsy shows profound germinal center reaction with infiltration of plasma cells (H&E stain, x400).
case_images: jkms-20-506-g001.jpg
case_images: PMC2782213_01_jkms-20-506-g001.jpg
case_images: F1
case_images: BM aspirate, plasma cells were 18.2% of the nucleated cells. BM biopsy revealed normocellular marrow with multifocal increase of plasma cells that were normal in morphology and maturation (Fig. 1A). LN biopsy revealed extensive infiltration of plasma cells (Fig. 1B).
case_images: Immunofluorescence staining of CD27 on CD19+ peripheral blood B cells at baseline (A) and 3 months after treatment (B). At baseline, there was marked increase of CD19+/CD27high plasma cells and significant reduction of CD19+/CD27+ memory B cells. After treatment, reduction of mermory B cells with abnormal plasmacytosis was no longer observed. P, plasma cell; M, memory B cell; N, naive B cell.
case_images: jkms-20-506-g002.jpg
case_images: PMC2782213_01_jkms-20-506-g002.jpg
case_images: F2
case_images: Immunofluorescence staining of the peripheral B cells revealed marked increase of CD19+/CD27high plasma cells and significant reduction of CD19+/CD27+ memory B cells (Fig. 2A). Upon follow up immunofluorescence staining of the peripheral B cells, reduction of memory B cells with abnormal plasmacytosis was no longer observed (Fig. 2B).