Sorry, that is
The correct diagnosis is:
Plasmacytoma (multiple myeloma)
- This is a cellular specimen with numerous single cells showing plasmacytoid features. Cells vary from mature plasma cells to large pleomorphic mono- and multinucleate cells that have large nuclei with finely granular chromatin.
- Cells have a moderate amount of dense cytoplasm and well defined cell membranes.
- These features suggest a metastatic plasmacytoma (multiple myeloma).
- In this patient a previous bone marrow biopsy revealed a plasma cell myeloma, consistent with the malignant cells that metastasized to the breast.
- Plasma cell myeloma is a clonal neoplasm of plasma cells and is synonymous with multiple myeloma, myelomatosis, and Kahler Disease.
- Single tumours are generally referred to as plasmacytoma and multiple tumours as multiple myeloma.
- This tumour affects more males than females, is rare before the age of 30 and peaks between the ages of 50-80.
- It is the most common primary bone tumour, but it is a rare form of cancer. Solitary plasmacytomas are especially rare in the breast and most often seen in the head and neck area.
- Neoplastic plasma cells are positive for PAS, methyl green pyronine, LCA and vimentin and are clonal for cytoplasmic light chain.
- In differentiated forms, Russell bodies (intranuclear inclusions containing immunoglobins) and cytoplasmic globules are also present.
- A cytologic diagnosis of multiple myeloma may be confirmed using immunoelectrophoresis to detect Bence Jones or myeloma proteins. Amyloid, although not seen in this case, may be occasionally present.
- Neoplastic plasma cells can resemble cells from an array of poorly differentiated neoplasms. Immunoblastic cells with binucleation and prominent nucleoli mimicking Reed Sternberg cells may be present.
BACK TO IMAGES
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