IgM Lambda Globular Cytoplasmic Inclusions in Chronic Lymphocytic Leukaemia Resembling Immunocytoma

Abstract

In a 64‐year‐old female with chronic lymphocytic leukaemia, nearly 50 % of the lymphocytes presented one or several globular intracytoplasmic inclusions resembling Russell bodies which were characterized by immunofluorescence as IgM lambda. On electron microscopy, the inclusions looked like cisternae of the rough endoplasmic reticulum. Surface membrane Ig was not detected and the serum IgM was low. The histology of a lymph node showed a lymphocytic proliferation with evidence of Ig synthesis, compatible with immunocytoma. The aggressive course of the disease necessitated polychemotherapy. This case represents an unusual ill‐defined lymphoproliferative disorder, lying between the B‐CLL and a non‐secretory macroglobulinaemia.

“Rod-Like” Cytoplasmic Crystals of Peripheral Lymphocytes in Chronic Lymphocytic Leukemia

“…In our case, the levels of IgG, IgA, and IgM were all reduced, with the most significant reduction seen for IgG at 4.96 g/L. While some observations of similar rod-like structures have been reported in cases of B-cell lymphoproliferative diseases, intracellular rod-like crystals in mature lymphocytes in CLL are extremely rare in peripheral blood [ 5 , 6 , 7 ]. Here, the crystals in the lymphocytes were present after anti-leukemia therapy.…”

Cytoplasmic Inclusions in Lymphocytes of Chronic Lymphocytic Leukaemia

“…In the electron microscope, the cytoplasmic inclusions appear as membrane-bound bodies within the cisternae of rough endoplasmic reticulum. From the morphological point of view, the cytoplasmic inclusions can show a square, rectangular, rhombic (7-9), rounded or oval shape (1). In our first case.…”

“…Berrebi et a1 (1) have recently described a case of chronic lymphocytic leukaemia (CLL) with IgM lambda globular cytoplasmic inclusions in lymphocytes. On electron microscopy, the inclusions looked as if they were within the cisternae of the rough endoplasmic reticulum.…”

Chronic lymphocytic leukemia cytoplasmic inclusions

“…The presence of cytoplasmic crystalline inclusions in lymphocytes of CLL has been infrequently reported [1][2][3][4]. Different types of inclusions have been reported in CLL lymphocytes including vacuoles, crystals, and pseudocrystals.…”