Yamamoto T, Hishida A, Honda N, Ito I, Shirasawa H, Nagase M
First Department of Medicine, Hamamatsu University School of Medicine, Japan.
Arch Pathol Lab Med. 1991 Apr;115(4):351-4.
Systemic distribution of crystal-storing histiocytes, increasing in number, and widespread crystalline tissue deposition were found in a 75-year-old man with a 5-year history of IgG-kappa-type multiple myeloma associated with corneal opacity and chronic renal failure. Characteristic crystalline inclusions were present not only in myeloma cells but also in cornea, epithelial cells of glomeruli, tubuli, Bowman's capsules, and choroid plexus. Histiocytes had particularly infiltrated the renal interstitium. These inclusions were positive by immunofluorescence for kappa light and gamma heavy chains. By electron microscopy, the inclusions were filled with fine crystalline hexagonal columns, each possessing a core structure. Of various factors generally considered responsible for renal failure in multiple myeloma, marked infiltration of histiocytes and the nephrotoxic effects of light chain appeared most relevant in the present case.
在一名75岁男性中发现了晶体储存组织细胞的全身分布，其数量不断增加，且有广泛的晶体组织沉积。该患者有5年IgG-κ型多发性骨髓瘤病史，伴有角膜混浊和慢性肾衰竭。特征性晶体包涵体不仅存在于骨髓瘤细胞中，还存在于角膜、肾小球、肾小管、鲍曼囊和脉络丛的上皮细胞中。组织细胞尤其浸润了肾间质。这些包涵体通过免疫荧光检测κ轻链和γ重链呈阳性。通过电子显微镜观察，包涵体充满了细小的晶体六边形柱，每个柱都具有核心结构。在通常认为导致多发性骨髓瘤肾衰竭的各种因素中，组织细胞的明显浸润和轻链的肾毒性作用在本病例中似乎最为相关。
