Phagocytic Myeloma Cells: Report of a Case and Review of the Literature

Abstract

The authors have reviewed 17 cases of the phagocytic multiple myeloma, including seven cases reported in Japan but not cited in the English literature and an additional new case investigated in the authors' laboratory. They would like to add these Japanese cases to the English literature. The salient features of these 17 cases were summarized to have a better understanding of the clinical aspects as well as of the pathogenesis of the phagocytic myeloma cells. The following two clinical points should be noted: The erythrophagocytosis by myeloma cells may be responsible for the hemolytic anemia in multiple myeloma. Myeloma cells were found in the peripheral blood in more cases of this series than expected. The pathogenesis of this phenomenon, related to the cellular origin of plasma cells, may be interpreted differently, as discussed in this report.

Phagocytic myeloma cells in asymptomatic multiple myeloma.

“…Phagocytic plasma cells have been reported exclusively in multiple myeloma (Kanoh and Fujii 1985;1986 These cases indicate that the ability to phagocytize may represent the nature, acquired through a process of malignant transformation, of plasma cells, or one of the changes induced by chemotherapy, rather than the inherent nature of the precursor cells in the plasma cell line (Kanoh and Fujii 1986). Phagocytizing plasma cells were observed in 6 (1.6%) among 382 patients with multiple myeloma (Kanoh and Fujii 1986).…”

Malignant Histiocytosis in Cattle.

“…Malignant histiocytosis is morphologically characterized by phagocytosis, especially of red blood cells, by tumor cells, but this phenomenon is not usually a conspicuous feature in human beings [3], and has been observed in other hematopoietic neoplasms, such as monocytic leukemia, myeloblastic leukemia [5] and plasmacytoma [7]. Erythrophagocytosis was seen also in bovine monocytic [12] and myeloblastic [18,19] leukemias, which had morphological features of immature monocytes and granulocytes, respectively, and which were quite unlike malignant histiocytosis.…”

Immunoglobulin D: Properties, Measurement, and Clinical Relevance

“…From 60% (14) to 90% (65) of IgD myelomas are of the type. The rarity of IgD secretion was explained by a block in the assembly, glycosylation, and secretion of this immunoglobulin or rapid intracellular catabolism of IgD destined for secretion (70). There is antigenic heterogeneity among monoclonal IgDs (probably allotypic variants, not subclasses, of IgD) (115,129).…”