Ascites fluid, 59-year old male with ascites, abdominal pain, and weight loss
Multiple myeloma, peritoneal involvement
Drs. Prolla and Diehl's
INTERESTING CASE OF THE MONTH June 2004 answer
Multiple myeloma, peritoneal involvement
Drs. Prolla and Diehl's INTERESTING CASE OF THE MONTH June 2004 answer
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Presence of many cells in apoptosis. Presence of many lymphoblast-like cells, with basophilic cytoplasm, in the M-G-G stain. Nuclei with thick membrane, several chromatin clumps in their periphery, in the Papanicolaou stain. Flow cytometry of the ascites fluid revealed: CD138 + (88.5% of the cells), CD38 + (97%), CD45 + (7%), CD3 + (11%), CD20 + (3%). Lambda light chain (cyto): 89.5% of the cells. The morphology and flow cytometry data (predominance of CD138 and CD38 positivity, small percentage of cells positive for CD45, CD3, and CD20, and Lambda light chain positivity in 89.5% of the cells), are consistent with peritoneal involvement by multiple myeloma. The patient initially responded to chemotherapy for multiple myeloma, but abandoned treatment, and died shortly after.
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