Case Slide No.:
CRUSH PREP. with MARROW SMEAR:
New features in this field include a trilobed myeloma cell and a large Dutcher body (to the right of dead center). The former does little to alter the diagnosis or behaviour of the disease. Neither does the Dutcher body, a relatively common finding in many myelomas.
Dutcher bodies represent cytoplasmic nuclear invaginations. They are variably PAS positive. On a percentage basis, they are most commonly encountered in the cells of Waldenstrom macroglobulinemia (WM). However, they are also commonly found in cells of multiple myeloma. Since myeloma is much more common than WM, the overall frequency of these bodies is higher in the former. Not only are Dutcher bodies encountered in myeloma and in WM, but they are also occasionally found in small lymphoid malignancies including small cleaved follicular center cell lymphomas and in very rare cases of amyloidosis associated with monoclonal expression of IgM. (Morphologic manifestations of monoclonal gammopathies. Reed M, McKenna RW, Bridges R et al. Am J Clin Pathol 1981; 76(1): 8-23).