PMC8302404_01
(a) BM aspirates suggesting plasma cell proliferation (Wright's stain) (x1000). (b) Peripheral blood smears showing significantly Rouleaux formation and plasmacytoid (Wright's stain) (x1000). (c) Bone marrow biopsy showing plasma cells proliferation. (d) Plasma cells positive for CD138 (x400). (e) Small to medium-sized atypical lymphoid cells in the lymph node (hematoxylin and eosin stain) (x400). (f) Vascular proliferation (hematoxylin and eosin stain) (x100). (g) Small to medium-sized cells positive for CD3 (x400). (h) CD21-positive follicular dendritic cell meshworks (x400). (i) B cells positive for CD20 (x400). (j) Multiparameter flow cytometry showing polyclonal plasma cells proliferation in the bone marrow. (k) Multiparameter flow cytometry showing polyclonal B cells in the bone marrow.
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fig1
Morphologically, PC accounted for ~54% in BM aspiration (Figure 1(a)) and ~44% in PB smear (Figure 1(b)). Multiparameter flow cytometry (MFC) in BM showed polyclonal PC proliferation with a proportion of ~45.9% (Figure 1(j)). CD2, CD3, CD5, CD7, CD43, and PD1, and they were negative for CD20, CD10, and BCL6. CD21, CD23, and CD35 showed irregular FDCs proliferation (Figures 1(e)-1(i)). The results of this patient's examination are shown in Figure 1.
PMC8302404_02
(a) Bone marrow aspirate suggesting Rouleaux formation and plasma cell proliferation (Wrights stain) (x1000). (b) Bone marrow biopsy showing plasma cells proliferation and plasma cells distributed in patches (May-Giemsa stain) (x400). (c) Plasma cells positive for CD138 (x400). (d) Ascites abscess cytology showing large amount of plasma cells with few lymphocytes (Wrights stain) (x400). (e) Small to medium-sized atypical lymphoid cells in the lymph node (hematoxylin and eosin stain) (x400). (f) Neoplasm cells positive for CD3 (x400). (g) CD21-positive follicular dendritic cell meshworks (x400). (h) Neoplasm cells positive for PD-1 (x400). (i) Part of lymphocytes (40-50%) was EBV positive (x400). (j) Multiparameter flow cytometry showing abnormal phenotype T lymphocytes in the lymph node. (k) Multiparameter flow cytometry showing polyclonal plasma cells proliferation in ascites. (l) Multiparameter flow cytometry showing mature B cells with light chain negative in ascites.
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fig2
The results of this patient's examination are shown in Table 1 and Figure 2.