PMC8490046_01
Ascitic fluid cytology showing large immature cells, some of which are multinucleated and admixed with smaller mature looking plasma cells. (a) 200X magnification. (b) 500X magnification. (c) 500X magnification showing large cell with multilobed nucleus.
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fig1
CD45, moderate positivity for CD138, lambda-restriction, and was also positive for CD19, CD38, and CD56, and negative for CD20 (Figure 1). Cytogenetics showed 5% of nuclei with three copies of 1q and 2 copies of 1p with no evidence for gains or losses of chromosome 5; deletions of 13q14.2, 14q32.3 (IgH), or 17p13 (TP53); or an IgH rearrangement.
Lymph node biopsy. (a) 4X magnification showing infiltration of the node with abnormal uniform looking cells. (b) 200X magnification for Ki67 highlighting >90% of cells. (c) 200X magnification of CD138 stain.
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fig2
He also underwent biopsy of the node in the diaphragmatic region, and pathology was consistent with plasma cell myeloma with anaplastic morphology with an immunophenotype like the ascitic fluid (Figure 2).