Plasmocyte Infiltration Research Articles

Rosai–Dorfman Disease

Rosai-Dorfman disease, also known as sinus histiocytosis with massive lymphadenopathy, is a benign proliferative disorder of histiocytes with an unknown etiology. It is a rare disease characterized by overproduction and accumulation of histiocytes within lymph node sinuses and many other extranodal sites, including skin, oral and nasal cavities, respiratory tract, eyelid, and periorbital area. In this case, a 44-year-old woman with diagnosis of Rosai-Dorfman disease, with xanthelasma-like cutaneous lesions on facial area, extending to her neck and acneiform papules on her back, cervical lymph node involvement, and concomitant presence of diabetes insipidus was presented. Histopathological examination of the lesions demonstrated diffuse lymphocyte, plasmocyte, eosinophil, and sparse neutrophil infiltration, together with histiocytes showing phagocytosed inflammatory cells (emperipolesis). Histiocytes demonstrated immunoreactivity with the antibodies for CD68 and S100, whereas they were negative for CD1a and Langerin. Laboratory tests were normal, except mild immunoglobulin G hypergammaglobulinemia. Systemic methylprednisolone therapy was effective for cutaneous lesions.

Effect of Cauterization on the Subconjunctival Fibrovascular Reaction in Rabbit Eyes

ABSTRACTObjective: The purpose of our study is to investigate the effect of episcleral cauterization during conjunctival autograft surgery on subconjunctival fibrovascular reaction in rabbit eyes. Methods: Twenty-four healthy male New Zealand white rabbits were divided into Control Group (n = 12) and Cautery Group (n = 12). In the Control Group, a 4 × 4 mm free conjunctival graft was elevated, the underlying Tenon’s capsule was excised, and the free graft was sutured back to its original place with 10-0 nylon sutures. In the Cautery Group, in addition to the same surgical steps, the episclera was cauterized with six gentle touches before the conjunctival graft was sutured back to its original place. The scleroconjunctival block of the operated area was excised at the first month. The sections were stained with hematoxylin and eosine and Masson trichrome and were evaluated using light microscopy. Results: Subconjunctival collagen fibers were increased, and the fibroblast density increased more significantly in the Cautery Group than in the Control Group. The groups were similar regarding vascularization, lymphocytic, and plasmocytic infiltration. Macrophage density was normal in all animals in both groups. Conclusion: Our histopathological examinations indicate that cauterization seems to lead to an increase in subconjunctival fibrosis at the first postoperative month in rabbit eyes.

Failure of bortezomib to cure acute antibody‐mediated rejection in a non‐compliant renal transplant patient

Bortezomib has appeared recently as a potential active treatment for acute AMR for few years. We reported a patient who received two courses of bortezomib for the treatment of an acute AMR associated with de novo HLA DSA that occurred 18months after renal transplantation because of non-compliance. Graft biopsy revealed features of acute humoral rejection with plasmocyte infiltration and C4d staining. Bortezomib was associated with corticosteroid pulses, IVIgs, and PP. Despite this rapid management, the patient lost his graft and carried on dialysis. Bortezomib therapy in addition to current therapy of AMR is not always effective in the treatment for late acute AMR in renal transplantation. We discuss on the place of such a treatment and other therapeutic strategies in this indication.

The First Report about Allopsoroptoides galli n. g., n. sp (Acari: Analgoidea: Psoroptoididae) Infected Layer Hens: Hematological, Serum Chemistry, and Histopathologic Findings

We have reported the first record of an exotic species of mites from an avian host of the order Galliformes in Bastos region, State of Sao Paulo, Brazil. The new feather mite was identified as Allopsoroptoides galli n. g., n. sp. (Acari: Analgoidea: Psoroptoididae). The hens parasitized by mites had intense itching, desquamation and marked drop in egg production (between 20-30%). Based on th e observed signals, this study aimed to verify the influence of parasitism on the blood profile, biochemical and histopathological changes in infested chicks. The infected hens showed hematocrit decrease, leukocytosis and eosinopenia. In serum chemical were observed decrease of alkaline phosphatase (ALP) and creatinokinase (CK) and increase of gama glutamiltransferase enzymes (GGT), cholesterol, and total serum protein. All infected cases had skin lesions such as: hyperkeratosis, inflammatory heterophilic infiltration; hydropic degeneration and mixed cellular infiltration of lymphocytes and plasmocytes. The histopathological observation on the kidney in infected hens showed mild changes such as degeneration of kidney tubules, pyknosis and hemorrhage. The liver of birds infested presented infiltrates of mononuclear cells and vacuolation. It can be concluded that feather mite's infection causes serious damage to the hens. These results could be really useful to assist diagnosis and prognosis of this infection.

Atypical central nervous system Whipple's disease: a case report and review of the literature

Objective To report the first case of central nervous system Whipple's disease (WD) with relatively good prognosis in China and present a brief review of central nervous system WD so as to improve the understanding of the diagnosis and treatment of this rare disease. Methods The clinical data of diagnosis, treatment and prognosis of one case of 35-year-old female was analysed in detail. Results Headache, hemiplesia and dementia were the main symptoms of this case and hypercranial pressure crisis occurred. During the course of disease, the patient successively presented paroxysmal extremity convulsion, right leg weakness, urinary incontinence, overeating, body mass increase. Despite of high dose of corticosteroid, penicillin and compound sulfamethoxazole were used, no effect was seen. Along with the increasing of intracranial pressure, cerebral hernia occurred. Cerebrospinal fluid examination indicated that glucose and chloride were normal while protein was obviously increased to 1700 mg/L. Electrocardiography (EEG) showed slow wave in right frontal and temporal lobes. Serial magnetic resonance imaging (MRI) revealed mutiple long T1 and long T2 signals mainly in right cerebral hemisphere, frontal parietal temporal lobes, semioval center and basal ganglion, with edema and irregular loose contrast and extended to left cerebral. Brain biopsy showed large pieces of necrosis at right fronto-temporal lobe with massive infiltration of lymphocytes and plasmocytes at perivascular and brain tissue, and exudation of glitter cells. Positive PAS and methenamine silver staining revealed bacterial particles inglitter cells. Central nervous system tumor, demyelinating disease and inflammatory pseudotumor were excluded. Both clinical symptoms and neuroimging recovered well after regular antibiotic therapy. Conclusion Central nervous system WD is a rare disease with complicated symptoms and imaging characters challenging diagnosis and treatment. The pathological findings may only indicate a special infection of central nervous system with unknown origin. The management is difficult. The misdiagnosis rate and fatality are high. It is important for clinicians to be aware of the features of this disease and make early decision to perform brain biopsy for diagnosis. Once it is diagnosed, normalized therapy should be given. DOI：10.3969/j.issn.1672-6731.2011.05.017

Prognostic Significance of Morphological Evaluation of Tumor Cells in Multiple Myeloma.

Abstract 4889Multiple myeloma (MM) is the second most common hematological malignancy. It is caused by clonal proliferation of terminally differentiated cells of B-lineage. Morphology assessment including the determination of plasma cell percentage in the bone marrow remains one of the basic diagnostic procedures even in the era of genomics. The objective of this study was to evaluate the prognostic impact of the presence of different plasma cell morphological subtypes on overall treatment response and long-term survival. We also analyzed whether this parameter can be correlated to other conventional prognostic/predictive markers. Our cohort consisted of 139 newly diagnosed MM patients who subsequently underwent autologous transplantation (AT) within the 4W and CMG 2002 clinical trials in a single center. Percentage of plasma cell subtypes in the bone marrow was evaluated based on the progressive nucleolus analysis, assessment of nuclear chromatin, and the nucleus/cytoplasm (N/C) ratio. A combination of these elements permits differentiation of eight subtypes P000-P111 and four subclassifications. Mature plasma cells (P000, P001) were found in 42.4% of patients; type I proplasmocytes (P010, P011, P100) in 38.1% of patients; and type II proplasmocytes (P101, P110) in 19.4% of patients. For patients undergoing AT, there was a statistically significant association between the presence of P000 subtype and overall treatment response whereas group of patients with overall therapeutic response ORR has lower number of mature plasma cell (P000 subtype) than patients without treatment response (median 24.0% vs. 36.0%, p = 0.032). Patients with <10% bone marrow infiltration by mature plasmocytes (P000 subtype) had shorter overall survival compared with patients with P000 percentage of ≥37% (46.8 months vs. 77.8 months; p = 0.020). The presence of <3% proplasmocytes (P110 subtype) was associated with longer time to progression compared with P110 ≥31% infiltration (median: 54.6 months vs. 22.4 months; p=0.045). Patients in ISS stage 1 or 2 had lower percentage of P010 (type I) proplasmocytes than patients in stage 3 (11.5% vs. 23.0%; p=0.030). In contrast, higher infiltration of P100 (type I) proplasmocytes and P101 (type II) proplasmocytes was observed in patients in 1-2 ISS stage compared with stage 3 patients (12.0% vs. 6.5%; p=0.015 for P100 and 1.0% vs. 0.0%; p=0.046 for P101). Patients without deletion of 13q14 chromosome had higher bone marrow percentage of mature P000 plasmocytes than patients with deletion of 13q14 (35% vs. 13%; p=0.014). Deletion of 13q14 was also associated with lower number of type II P110 proplasmocytes (36.5% vs. 6.0%; p=0.012). Despite advances in high-tech genomic technologies, evaluation of plasmocyte infiltration of the bone marrow still belongs to basic diagnostic procedures in MM and further morphological subtyping of plasmocytes should provide important prognostic information for MM patients treated by autologous stem cell transplantation. Supported by grants MSM 0021622434, MŠMT LC06027, MZCR NR9225-3 and IGA NR9225-3. DisclosuresNo relevant conflicts of interest to declare.

Extranodal Rosai-Dorfman disease of the kidney

Extranodal Rosai-Dorfman disease of the kidney

Endométrite chronique pseudolymphomateuse

Chronic endometritis is a rare entity characterized by an endometrial plasmocytic infiltrate. The lymphoid infiltrate may be abundant and simulate a lymphoma of the uterus. We report two cases of lymphoma-like lesions of the endometrium in two postmenopausal women of 79 and 89 year-old, who presented with abundant vaginal discharge. Ultrasound examination revealed in both cases an intrauterin polypoid lesion. Histologically, a predominantly plasmocytic infiltrate was seen in the endometrium destroying endometrial glandes and extending into the superficial myometrium, in the first case. Immunohistochemical study showed a polymorphic lymphoid infiltrate with a predominance of Tcells. Molecular study revealed a polyclonalB cell population, distinguishing the lesion from a marginal zone lymphoma. Lymphoma-like lesions of female genital tract must be distinguished from malignant lymphoma that rarely occurs in this site.

Macroglobulinemia de Waldenström - remissão completa após tratamento com rituximabe

Waldenstrom's macroglobulinemia is a rare pathology of B lymphocytes characterized by the production of monoclonal IgM, causing clinical manifestations which may include fatigue, asthenia, weight loss, bleeding of the mucosa and intestinal tract, lymphadenomegaly, hepatosplenomegaly and neurological alterations. The disease is more frequent among elderly patients and its symptoms are a result of the hyperviscosity of blood. Waldenstrom's macroglobulinemia presents hypergammaglobulinemia with a monoclonal peak of serum proteins seen by electrophoresis, high IgM levels and other normal or diminished immunoglobulin levels, immunophenotyping with CD19+, CD20+ and CD24+ B lymphocytes aspirated from hypercellular bone marrow and hypercellular bone marrow biopsy with diffuse infiltration of lymphocytes, plasmocytoid lymphocytes and plasmocytes. Currently, monoclonal antibodies are successfully being used in the treatment of Waldenstrom's macroglobulinemia. Rituximab, an anti-CD20 monoclonal antibody, has shown excellent results in the treatment of Waldenstrom's macroglobulinemia even for individuals who did not obtain satisfactory responses to conventional treatment. This work reports the case of a 78-year-old woman with a history of fatigue, asthenia, anorexia, somnolence, restlessness, urticaria, difficulties in walking, and excessive weight loss (approximately 22 Kg within a period of 5 months) who was successfully treated using rituximab. The objective of this report is to present the case of this patient and to review current clinical and therapeutic aspects of the disease.

Deux cas de kératose lichénoïde chronique dans une même fratrie. Réponse favorable à la photothérapie UVB

Keratosis lichenoides chronica (KLC) is a rare chronic keratinisation disorder. Out of almost 60 published cases of KLC, only two report its occurrence in siblings. We report a new case in which a brother and sister present KLC that improved markedly with UVB phototherapy. A 10-year-old girl presented with hyperkeratotic papules symmetrically arranged in a reticular pattern on the face and the extremities. Onset occurred at the age of six months. For a number of years, minimum sunlight was allowed owing to a diagnosis of lupus. However, KLC was our first diagnostic assumption, confirmed by an elbow lesion biopsy sample. The patient's brother, one and a half years old, had been presenting similar lesions since the age of two months. Sibship was demonstrated by DNA analysis using short tandem repeat markers. No consanguinity was found. After one month of narrow-band UVB phototherapy, most of the papules had flattened. KLC is uncommon in childhood and familial occurrence is very rare. Clinically, thick keratotic papules arranged in parallel lines or small networks cover the dorsal aspects of the limbs symmetrically. The face may be affected by a seborrhoea-like dermatitis. Histology typically shows alternating acanthosis and atrophy, with focal parakeratosis. An extensive lichenoid lymphohistiocytic and plasmocytic infiltrate is demonstrated in the dermis. The course is chronic. Spontaneous resolution may occur. Sunlight has been shown to be effective in the few paediatric cases reported. Narrow-band UVB phototherapy appears to be an effective therapeutic option.

Autoimmune Hepatitis Associated with Pulmonary Arterial Hypertension

A 46-year-old woman presented with arthralgia. She had a history of fluctuating liver function impairment for 6 months. Laboratory investigations revealed elevated liver function test results, positive antinuclear antibodies and elevated serum IgG. The histological findings of a liver biopsy were interface hepatitis accompanied by plasmocytic infiltration with bridging fibrosis. There was no evidence of cirrhosis on pathological examination and no portal hypertension on endoscopic and radiographic studies. Autoimmune hepatitis was diagnosed, and treatment with prednisolone improved the liver dysfunction. After 6 months, she complained of dyspnea. Doppler echocardiography showed a dilated right ventricle, severe tricuspid insufficiency, and systolic pulmonary arterial pressure indicative of pulmonary arterial hypertension. We report this rare case of autoimmune hepatitis with pulmonary arterial hypertension.

Bone formation in cardiac valves: a histopathological study of 128 cases

In a series of 1,177 patients with surgical valve resection, there were 128 (10.9%) patients with the histological finding of bone and/or cartilage formation (bony metaplasia; heterotopic ossification) in the excised valve (119 aortic, 9 mitral). The incidence was higher in men (12.8%) than in women (8.5%). The bony metaplasia was always associated with valvular calcification. The metaplastic changes were encountered in all types of calcific aortic valve disease (senile, bicuspid valve, post-rheumatic). The marrow of the heterotopic lamellar bone was mostly composed of adipose tissue. Frequently, it showed chronic inflammation with polyclonal plasmocytic infiltration. Complete haematopoiesis was present only rarely.

Helicobacter spp. In gastroscopic biopsies in dogs

This paper includes 50 dogs, differing in breed and sex, from 3 months to 12 years of age: 26 samples of endoscopic stomach biopsies were taken from ill animals which displayed chronic vomiting, 12 endoscopic biopsy samples of healthy dogs and 12 stomach samples of autopsied dogs. Helicobacter spp. and Gastrospirillum hominis findings were confirmed in 20 of the 26 ill dogs, 8 of the 12 autopsied animals, and 2 of the 12 healthy animals by histopathology and direct gastric tissue smears. In 26 endoscopic biopsies various clinical and endoscopic findings (7 cases of erosive and 4 of ulcerous gastritis, 12 cases of chronic gastritis and 2 of gastric reflux) were previously determined. Histopathological examination of stomach mucosa of 5 autopsied and Helicobacter positive dogs determined focal lymphocyte infiltrations, mainly located in the subglandular region. Along with such lymphocyte accumulations, in certain cases a diffuse infiltrate consisting of eosinophilic granulocytes and plasma cells was also present. In most biopsied samples, stained with hematoxylin-eosin, histopathological changes were not observed, except in 5 dogs where diffuse lymphocyte infiltration of the mucosa was noted and in two dogs with signs of chronic gastritis, that is hypertrophy and stratification of the mucosa epithelium, and with lymphocyte and plasmocyte infiltration. By modified Giemsa staining of 20 of the endoscopically biopsied animals, spiral microorganisms with varying numbers of spiral curves were observed, which were similar to the necropsy stomach mucosa samples, belong to various types of Helicobacter spp, and some of them morphologically correspond to Gastrospirillum hominis.

C-met Receptor as a Potential Target for the Treatment of Patients with Multiple Myeloma.

Despite progress in the treatment of Multiple Myeloma (MM), it is still an incurable disease with average survival of 3–4 years. Because MM is often resistant to conventional therapies, new treatment strategies are necessary. The presence of elevated HGF (Hepatocytic Grow Factor) expression has been well documented in multiple myeloma. The c-met oncogene has been shown to be present in MM cell lines at the mRNA and protein level. Some data suggested that this axis could be responsible for proliferation and inhibition of apoptosis in MM cells.In this study we have analyzed c-met expression in 15 patients with (MM) before and after treatment. Seven of these pts responded well and eight pts responded poorly to the employed therapy. All 15 pts were c-met positive before therapy. Bone marrow cellularity of patients who responded well was 76% before (range: 10% – 100%) and 46% after treatment (range: 40% – 60%). In this group plasmocyte infiltration of bone marrow consisted of 59% before (range: 10% – 80%) and 9% after chemotherapy (range: 0% – 20%). Five of them had undetectable c-met positive cells among bone marrow cells after treatment. In the group of poor responders cellularity of bone marrow was 40% (range: 20% – 70%) before treatment and 46% (range: 20% – 70%) after therapy. Plasmocytes consisted of 20% (range: 10% – 50%) of bone marrow cells before and 44% (range: 10% – 90%) after treatment. All patients in this group had cells positive for c-met receptor after therapeutic regiment.This results suggested that c-met-HGF axis might be a good target for alternative therapy in MM. We looked for potential therapeutics that interferes with this axis and we found that geldanamycin (GA) has been shown to decrease expression of c-met at the protein level in several different cell types. Using inhibitors that belongs to geldanamycin family (GA, 17AAG and 17DMAG) we treated MM cell lines and primary sample. We found that these molecules strongly inhibited expression of c-met in both MM cell lines and patients sample as assessed by western blot analysis. We also tested the influence of these inhibitors on proliferation of MM cells. We found that 100nM dose of GA and 17DMAG inhibited growth of MM cell lines by 80% and 100nM dose of 17AAG inhibited growth of these cells by 20%. Primary cells were more resistant to treatment but we still obtained 30% inhibition with GA and 17DMAG. 17AAG was ineffective and proliferation decreased by less than 10%. Grow inhibition was probably not only due to c-met-HGF axis blockade because these molecules also inhibit other proteins (AKT, RAF). In our experiments we have shown that the level of c-met expression correlates with response to therapy. Patients who respond well had substantially decreased number of c-met positive plasmocytes after chemotherapy in comparison to poor responders. We have also showed that drugs that block c-met-HGF axis could be used in treatment of MM. These drugs could potentially inhibit cells proliferation, increase apoptosis and disrupt MM cells interaction with bone marrow environment. Based on these data we postulate that the c-met receptor is a potential target for MM therapy especially in patients who do not respond to the first line of treatment.

Clinical and histologic study of autogenous oral mucosa in experimental lamellar ketatoplasty

Eight male dogs of non-specified breed, weighing about 12,4 kg, were subjected to surgical oral mucosa detachment using among others a 5 mm diameter trepan followed by it fixation on 4,5 mm diameter corneal lesion made in an eye, using 9-0 nylon thread in interrupted simple suture pattern. The animals were divided to 4 groups constituted by 2 animals, for histologic study at 15, 30, 45, 60 days of post surgical phase. Meanwhile, clinical findings such as blepharospasm, opacity, neovascularization, ocular discharge, chemosis and characteristics of the graft (vascularization, pigmentation and adhesiveness), were qualitative and quantitatively evaluated at 0-2 days, 3-7 days, 8-15 days, 16-30 days and 31-60 days of postoperative period. Blepharospasm and chemosis were more intense at initial periods, corneal opacity and vascularization (of cornea and grafts) at intermediate periods, both with regressing tendency on the latest periods. Serous mucous exsudate was predominant in higher degrees at the initial and intermediate phases and was absent on the later phases. Clinically, the integration of the graft was verified at 15th day. Pigment deposition was seen on two animals on the later periods. The microscopic study revealed on initial and intermediate periods a thick epithelium in comparasion with the underlying cornea, with vacuolization of the inmost cells, intense fibroplasia and collagen fibers deposition on a disorganized setting and intense vascularization of the graft. Mild polymorphonuclear infiltration in graft was observed at 15th day. Plasmocyte infiltration at intermediate phase was mild to moderate. On the 60th day, were observed reasonably thick epithelium with projections to stroma, moderate presence of fibrocytes, collagen on a more organized setting, vascularization ranging from mild to absent and lymphoplasmocitary infiltration in moderate degree. The results allowed us to admit that keratoplasty technique employing buccal mucosa is feasible option for tectonic and reconstructive means in dogs.

Prognostic factors of cervical lymph node metastasis in head and neck squamous cell carcinoma.

The metastatic spread of squamous cell carcinoma of the head and neck (SCCHN) to the cervical lymph nodes is a negative prognostic factor in terms of survival. We have used multivariate analysis to identify the possible prognostic significance of a number of clinical and pathological characteristics in relation to possible involvement of the cervical lymph nodes in a series of 396 patients. 396 patients with SCCHN were studied. Variables regarding the patient, the carcinoma and histology were analysed by multivariate analysis using BMDP's PLR programme. Some variables appear to represent predisposing factors for tumor spread to the lymph nodes: tumor site (supraglottic larynx: P = 0.005; base of the tongue: P = 0.02; hypopharynx: P = 0.02), grading (P = 0.001), and a number of histological parameters (lower degree of histological differentiation: P = 0.001; vascular permeation: P = 0.04; perineural invasion: P < 0.05; prevalently plasmocytic infiltrate: P < 0.05). The identification of cases at risk for metastasis can be improved by the assessment of prognostic factors, with a consequent improvement in treatment strategies.

Examination of cutaneous macroglobulinosis by immunoelectron microscopy

Cutaneous macroglobulinosis is a rare cutaneous manifestation of Waldenström's disease. Lesions are though to result from accumulation of macroglobulin in the dermis and are therefore called IgM storage papules. Ultrastructural findings in the previously reported cases were contradictory and the nature of the deposits was not established by electron microscopy. The purpose of this study was to analyse such deposits by the use of immunoelectron microscopy. A 60-year-old woman had multiple erythematous papules for 1 year. The histopathological changes consisted of plasmocytic infiltration of the dermis and eosinophilic deposits. The skin changes and other investigations led to a diagnosis of Waldenström's disease. Samples from normal and diseased skin were analysed by electron microscopy and by immunogold labelling with anti-IgM antibodies, after Lowicryl K4M embedding. An extracellular electron dense granular and filamentous material was observed in the mid- and upper dermis, between and within the collagen bundles. No periodicity was noted and no deposits were seen at the dermoepidermal junction. Immunoelectron microscopy showed a positive labelling located only on these deposits, in both normal-appearing skin and in lesions. In this patient, immunoelectron microscopy clearly demonstrated the presence of large amounts of IgM in the dermis, which were found in the lesions of cutaneous macroglobulinosis and in normal skin. These results suggest that the IgM storage papules result from a greater density of deposits rather than a site-specific accumulation.

Leptomeningeal plasmacytosis: Case report and considerations on treatment

We describe a 68-year-old patient with a plasma cell leukaemia in haematological remission presenting with massive intracranial leptomeningeal plasmocytic infiltration (LPI) and hydrocephalus. He was treated with skull irradiation and a combination of intraventricular and lumbar intrathecal therapy with methotrexate. Neurologic improvement and clearance of plasma cells from the cerebrospinal fluid was reached after 2 weeks of treatment but prolonged follow-up was interrupted by a lethal gastro-intestinal haemorrhage, 6 weeks after starting the therapy. From previously reported cases it is known that LPI almost always occurs in either high-grade plasmocytomas or plasma cell leukaemia. These data suggest that therapy of LPI should be the same as in other leukaemias with leptomeningeal infiltration.

Changes of mast cells in the inflammatory foci

The localization and appearance of mast cells of acute and chronic inflammatory processes of the paranasal lesions in the cases of chronic sinuitis were examined pathohistologically in this paper.Mast cells were seen around and/or attached to the small blood vessels in the connective tissue. Mast cells were easily found in the acute exsudative inflammatory foci, but scarcely in the areas of lymphocytic, plasmocytic, and histiocytic infiltration of the chronic inflammatory stage. Mast cells were found scatteredly in the areas of the proliferation of collagen fibers or fibrosis.In the acute inflammatory process with neutrophilic and eosinophilic infiltration mast cells showed the degranulation and the degrees of the degranulation of mast cells varied. The mast cells were occasionally seen as the clear cells.It seems that mast cells have active behaviours in the early stage of the inflammatory processes and play an important role in fibrosis in the repair stage of the inflammatory processes human-pathohistologically.

Serum β&lt;sub&gt;2&lt;/sub&gt;-Microglobulin, Serum Creatinine and Bone Marrow Plasma Cells in Benign and Malignant Monoclonal Gammopathy

Serum beta 2-microglobulin concentrations were determined in samples of 65 patients with benign or malignant monoclonal gammopathy. In the group of patients suffering from multiple myeloma or Waldenström's macroglobulinemia the mean beta 2-microglobulin level was significantly higher than in the group with benign monoclonal gammopathy. Values above 3 mg/l were highly indicative of malignant disease and observed in 50% of the myeloma patients. Serum creatinine levels were significantly correlated to beta 2-microglobulin levels. However, mean creatinine concentrations did not significantly differ between the two groups of patients. Plasma cells and lymphoplasmocellular elements containing cytoplasmic immunoglobulin were counted in bone marrow samples of all patients. The counts, expressed in percent of nucleated bone marrow cells, allowed a good discrimination between the benign and the malignant group of patients. Bone marrow from patients with multiple myeloma or macroglobulinemia contained more, from patients with benign monoclonal gammopathy less than 17% plasma cells. No significant correlation was noticed between the extent of this plasmocytic bone marrow infiltration and serum beta 2-microglobulin or creatinine levels.