19 August 2021
: Case report
Cardiac Amyloidosis Presenting with Pre-Excitation Syndrome, Heart Failure, and Severe Factor X Deficiency as Part of Systemic Amyloid Light-Chain (AL) Amyloidosis – A Fatal Combination
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Educational Purpose (only if useful for a systematic review or synthesis)
Hussam Almasri1ABFG*, Ahmed Almeer1DEF, Samah Awouda2E, Omnia Hamid1E, Sundus Sardar
DOI: 10.12659/AJCR.933398
Am J Case Rep 2021; 22:e933398
Figure 2. (A) BM aspirate smear (Wright’s stain, 1000×) revealed scattered and clusters of plasma cells, averaged ~20%, morphologically abnormal, substantial number show deep condensed peripheral staining with flame plasma cell-like morphology, many appear granulated (lower right insert) or with immunoglobulin inclusions (Russell bodies, arrowed cell) and a few are binucleated (lower left insert) or have a pleomorphic nucleus. (B) Flow cytometry immunophenotyping on BM aspirate revealed 3% monotypic plasma cells (red population) expressing CD38/CD138 with cytoplasmic lambda light-chain restriction with aberrant CD56 and CD117 expression. Flow cytometry showed <1% residual polytypic plasma cells (blue population).