Kyle et al. 356 (25): 2582, Figure 1 June 21, 2007

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Figure 1. Bone Marrow–Biopsy Specimens from Two Patients with Smoldering Multiple Myeloma.

In Panel A, in which bone marrow cells from one patient have been stained with hematoxylin and eosin, plasma cells are difficult to discern by morphologic analysis alone. In Panel B, cells from the same specimen have undergone immunohistochemical staining for MUM1. Strong nuclear staining is present in the plasma cells, but this pattern leads to a slight underestimation of the number of plasma cells. In Panel C, immunohistochemical staining for CD138 on the same specimen shows strong cytoplasmic and Golgi staining in plasma cells, but this pattern results in a slight overestimation of the number of plasma cells. Thus, it is essential to combine the estimates of all methods to estimate the number of plasma cells accurately. In Panel D, a specimen from another patient with smoldering multiple myeloma shows monotonous plasma-cell aggregates filling interfatty marrow spaces (hematoxylin and eosin). In Panel E, immunohistochemical staining for CD138 on the same specimen shows plasma-cell aggregates filling interfatty marrow spaces.