Nakamine H, Nishihara T, Saito K, Takenaka T, Maeda J
Am J Clin Pathol. 1982 Oct;78(4):549-55. doi: 10.1093/ajcp/78.4.549.
A case of a patient with needle-shaped inclusions in plasma cells was reported. Some of the inclusions were positively stained for acid phosphatase and beta-glucuronidase. Ultrastructurally, each inclusion was surrounded by a single limiting membrane without any relation to rough-surfaced endoplasmic reticulum and composed of numerous fine fibrous bundles. By the enzyme-labeled antibody technic, the inclusions were found as "stain defects" in IgG-forming plasma cells, but not in IgM-forming plasma cells. Although the exact nature of the inclusions could not be clarified, they were quite different from both amyloid fibrils and immunoglobulin-derived inclusions, and were thought to be synthesized by a clone of differentiated plasma cells. The patient showed moderate hypogammaglobulinemia but no evidence of a direct correlation between the inclusions and hypogammaglobulinemia was obtained. Though the possibility that the case was non-secretory myeloma could not be ruled out, it was unlikely judged by the findings of various examinations.
报告了一例浆细胞内有针状包涵体的患者。部分包涵体酸性磷酸酶和β-葡萄糖醛酸酶染色呈阳性。超微结构显示，每个包涵体被单个界膜包绕，与糙面内质网无关联，由大量细纤维束组成。通过酶标抗体技术发现，这些包涵体在形成IgG的浆细胞中表现为“染色缺陷”，而在形成IgM的浆细胞中未发现。尽管包涵体的确切性质尚不清楚，但它们与淀粉样纤维和免疫球蛋白衍生的包涵体均有很大不同，被认为是由一群分化的浆细胞合成的。该患者表现为中度低丙种球蛋白血症，但未发现包涵体与低丙种球蛋白血症之间存在直接关联的证据。尽管不能排除该病例为非分泌性骨髓瘤的可能性，但根据各项检查结果判断这种可能性不大。
