ABSTRACT
We report two unusual manifestations of multiple myeloma in a 71-year-old man. Late in the course of his disease, myeloma cells were observed in the patient's urinary sediment. At post mortem, the source of the cells was found to be a plasmacytoma of the urinary bladder. To our knowledge, this appears to be the first report of a clearly demonstrable anatomic source for myeloma cells in the urine.
Subject(s)
Multiple Myeloma/urine , Urinary Bladder Neoplasms/urine , Aged , Autopsy , Humans , Male , Multiple Myeloma/pathology , Plasmacytoma/pathology , Plasmacytoma/urine , Urinary Bladder Neoplasms/pathologyABSTRACT
Histochemical and microscopic studies have shown that a characteristic renal response to lead exposure is the formation of discrete, dense, staining intranuclear inclusion bodies in renal tubular epithelial cells. Cytologic examination of urinary sediment showed that four of 19 (21%) lead workers had exfoliated inclusion-bearing cells of proximal renal tubular origin. These lead-induced inclusion-bearing cells appeared distinctly different from viral-induced inclusions, degenerative or nonspecific intranuclear inclusions seen with tubular necrosis, or macronucleoli seen in reparative renal tubular epithelium. While their presence indicates cytologic evidence of tubular injury, the clinical significance of these cells and their application to medical monitoring is not clearly understood.
