Abstract
A 57-year-old female was admitted with pancytopenia, and mild splenomegaly. The multiple myeloma diagnosis was wrongly made since the discovery of monoclonal peak to the protein electrophoresis. Further microscopic examination of bone marrow revealed the accumulation of sea-blue histiocytes. The evolution was stable and the patient did not receive any treatment due to the lack of nervous symptoms.
Highlights
The syndrome of the sea-blue histiocyte is a rare disorder first described by Silverstein et alin 1970 [1]
Bone marrow biopsy showed a marrow made of wealth between 1 and 2, the seat of histiocytes with abundant cytoplasm vacuolated, the vacuoles are of unequal size, positive PAS staining and Giemsa negative for Perls stain, concluding the diagnosis histiocytosis of “blue sea”
Macrophages loaded with cytoplasmic granules staining blue with Giemsa, socalled sea-blue histiocytes, are commonly seen in various organs including the lungs in Niemann-Pick disease, and occasionally in the bone marrow and spleen as a seconddary phenomenon associated with a variety of acquired hematological disorders, such as chronic myelogenous leukemia, chronic immune thrombocytopenic purpura, myelodysplastic syndrome, and polycythaemia rubravera [4,5,6]
Summary
The syndrome of the sea-blue histiocyte is a rare disorder first described by Silverstein et alin 1970 [1]. It was given the name due to the histiocyte color upon May-Giemsa staining. This disorder is classified as either primary or secondary; most cases are secondary to lipid metabolic diseases. The clinical course is usually benign but some cases develop fatal liver cirrhosis [2,3,4]. We report a case of this syndrome with a review of the literature
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