2664J.Zhuetal. Figure1.(A)Peripheralbloodsmearshowedmaturelymphocyteswithonetomutipleneedle-shapedAuerrod-likecytoplasmicinclusions.(B)Bone marrowdisplayedsomeneoplasticcellswithAuerrod-likedelicatecytoplasmicinclusions.Wright–Giemsastain,1000.(C)Immunohistochemical stainingofsplenicneoplasticcellsshowedthemtobekappalightchain()and(D)lambdalightchain(). microscopy[15].WeperformedimmunohistochemicalPotentialcon?ictofinterest:Disclosureformsprovided stainingforkappaandlambdalightchainstoidentifythebytheauthorsareavailablewiththefulltextofthisarticleat inclusions.Immunohistochemistryshowedtheneoplasticwww.informahealthcare.com/lal. cellstobekappalightchainpositiveandlambdalightchain negative[Figures1(C)and1(D)]. Toourknowledge,weherereportthefirstcaseinChinaReferences ofspleniclymphoma,whichshowedlymphocyteswithvis- [1]YoshidaY,OgumaS,OhnoH.JohnAuerandAuerrods; iblecytoplasmdisplayingoneormoreazurophilic,needle-controversiesrevisited.LeukRes2009;33:614–616. [2]AuerJ.Somehithertoundescribedstructuresfoundinthelarge shapedstructuresresemblingAuerrods.Thefeatureof lymphocytesofacaseofacuteleukaemia.AmJMedSci1906;131: suchstructureswasdifficulttodistinguishfromtrueAuer 1002–1015. bodies,althoughthecirculatingcellsweremorphologi-[3]FreemanJA.TheultrastructureandgenesisofAuerbodies.Blood 1960;15:449–465. callymaturelymphocytecells,whichwereconfirmedasB [4]FreemanJA.OriginofAuerbodies.Blood1966;27:499–510. maturelymphocytesbyflowcytometry.Asweknow,there [5]HawksleyJ.AnoteontheoccurrenceofAuer’sbodiesinmonocytic isaroleofAuerrodsinthedifferentialdiagnosisofmyeloidleukemia.JPathBact1935;40:365–369. [6]AckermanGA.MicroscopicandhistochemicalstudiesontheAuer neoplasms,aspatienttherapyandprognosisaresignifi- bodiesinleukemiccells.Blood1950;5:847–863. cantlyimpactedbytheappropriatediagnosis.Inthiscase [7]SwerdlowS,CampoE,HarrisN,etal.WHOclassificationof theAuerrod-likeinclusion-containingcellsweremorpho-tumoursofhaematopoieticandlymphoidtissues.4thed.Lyon,France: IARCPress;2008. logicallyidentifiedasmaturelymphocytes.Thefollowing [8]DunphyCH,ChungD,DunphyFR.Auerrod-likeinclusionsinadult reasonsmightbehelpfultodifferentiateourcasefromAML commonacutelymphoblasticleukemia.HumPathol1994;25:211–214. andMDS.AMLshowsadiffuseandmonotonousinfiltrateof[9]HutterG,NowakD,BlauIW,etal.Auerrod-likeintracytoplasmic inclusionsinmultiplemyeloma.Acasereportandreviewofthe blastswithlittlevariationintheirshapeandsize,increased literature.IntJLabHematol2009;31:236–240. nuclear–cytoplasmicratio,finelydispersednuclearchro- [10]JunejaHS,RajaramanS,AlperinJB,etal.Auerrod-likeinclusions matinandprominentnucleoli;MDSshowsmorphologicinprolymphocyticleukemia.ActaHaematol1987;77:115–119. [11]GroomDA,WongD,BrynesRK,etal.Auerrod-likeinclusionsin dysplasiainoneormoreofthecelllineages;noneofthese circulatinglymphomacells.AmJClinPathol1991;96:111–115. characteristicswereapparentinourcase.Moreover,ancil- [12]TakahashiT,SuzukawaM,AkiyamaM,etal.Auerrod-like larytestings,suchasflowcytometryandimmunohisto-cytoplasmicinclusionbodiesinnodalmarginalzonelymphomacells. IntJHematol2009;89:133–134. chemistry,werecriticalinaccuratelyrecognizingthe [13]GoldbergAF.Anunusuallymphomatousdiseaseassociated neoplasticcellsaslymphocytesandnotimmaturemyeloid withintracytoplasmiccrystalsinlymphoplasmocytoidcells.Blood cells.Inconclusion,Auerrodsareoftenausefulmorpho-1960;16:1693–1707. [14]MetzgerothG,BackW,MaywaldO,etal.Auerrod-likeinclusions logicfinding,butwhichshouldbecarefullyreevaluatednot inmultiplemyeloma.AnnHematol2003;82:57–60. onlybymorphologicreviewbutalsobyimmunophenotyp- [15]KjeldsbergCR,BearmanRM,RappaportH.Prolymphocytic ingandimmunohistochemistry.leukemia.Anultrastructuralstudy.AmJClinPathol1980;73:150–159.
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