PMC10319461_01
(a) Serum immunofixation demonstrating a monoclonal IgE kappa (kappa) component, (b) interphase fluorescence in situ hybridization (FISH) with dual fusion probes for immunoglobulin heavy chain (IGH) and cyclin D1 (CCND1) showed a fusion signal corresponding to t(11;14)/IGH-CCND1 fusion (white arrow), and (c) interphase FISH with a probe for cyclin-dependent kinases regulatory subunit 1 (CKS1B), a chromosome 1q marker, showed four copies of CKS1B. ELP: serum protein electrophoresis.
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fig1
Serum protein electrophoresis and immunofixation electrophoresis confirmed the presence of IgE kappa (kappa) paraprotein (Figure 1(a)). Results of the fluorescence in situ hybridization (FISH) were negative for the translocations of FGFR3 and MAF and the deletion of 17p13 and 13q14 but positive for the CCND1/IGH fusion and the amplification (four copies) of 1q21, including CKS1B gene (Figures 1(b) and 1(c)).
Computed tomography revealed bilateral pleural effusion (a), multiple hypodense liver nodules (b-d), thickening of the stomach wall (b), ascites (b-d), and swelling of multiple lymph nodes (red boxes in (a-d)).
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A systemic examination with computed tomography (CT) confirmed bilateral pleural effusion, ascites, multiple hypodense nodules in the liver, thickening of the stomach wall, and multiple lymph node swellings (Figure 2).
Histopathological examination of biopsy samples from the liver and gastric mucosa. The plasma cells had diffusely infiltrated the liver (a-c) and gastric mucosa (d-f) (hematoxylin-eosin staining, x400). The plasma cells were positive for CD138 (b and e) and cyclin D1 (c and f) (x200). HE: hematoxylin-eosin staining.
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Needle biopsy of a liver nodule showed a diffuse infiltration of plasma cells, which were positive for CD138 and CCND1 (Figure 3). Pathological examination of the gastric mucosa biopsy revealed CD138-positive plasma cell infiltration (Figure 3).