Crystal-storing histiocytosis: A clinicopathological study of 13 cases

Rashmi Kanagal-Shamanna, Zijun Y. Xu-Monette, Roberto N. Miranda, Ahmet Dogan, Dehui Zou, Rajyalakshmi Luthra, Donna M. Weber, Dennis P. O'Malley, Jeffrey L. Jorgensen, Joseph D. Khoury, Carlos E. Bueso-Ramos, Robert Z. Orlowski, L. Jeffrey Medeiros, Ken H. Young

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Aims: Crystal-storing histiocytosis (CSH) is a rare lesion composed of histiocytes with abnormal intralysosomal accumulation of immunoglobulin (Ig) as crystals, reported in patients with plasmacytic/lymphoplasmacytic neoplasms. The aims of this study were to report the clinicopathological features of 13 patients with CSH, and to describe the proteomic composition of the crystals in three cases analysed by mass spectrometry (MS). Methods and results: There were seven men and six women, with a median age of 60 years (range, 33-79 years). CSH was generalized in one patient (8%) and localized in 12 (92%) patients, involving various sites. CSH was associated with a low-grade B-cell lymphoma with plasmacytoid differentiation or a plasma cell neoplasm in all cases. In 10 (77%) cases, CSH represented >50% of the neoplastic infiltrate. According to immunohistochemical studies, histiocytes were positive for monotypic kappa in 5 (50%) cases, and for monotypic lambda in 4 (40%) cases; in 1 (10%) case, the results were equivocal. MS analysis of the histiocyte contents in all three tested cases showed a predominance of variable-region fragments of Ig light and/or heavy chains. Conclusions: CSH is frequently associated with an underlying lymphoplasmacytic neoplasm. MS findings suggest that Ig alterations and/or possibly defects in the ability of histiocytes to process Ig play a role in pathogenesis.

Original languageEnglish (US)
Pages (from-to)482-491
Number of pages10
JournalHistopathology
Volume68
Issue number4
DOIs
StatePublished - Mar 1 2016
Externally publishedYes

Keywords

  • Crystal-storing histiocytosis
  • Immunoglobulin
  • Lymphoplasmacytic neoplasm
  • Mass spectrometry
  • Proteomic analysis

ASJC Scopus subject areas

  • Histology
  • Pathology and Forensic Medicine

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    Kanagal-Shamanna, R., Xu-Monette, Z. Y., Miranda, R. N., Dogan, A., Zou, D., Luthra, R., Weber, D. M., O'Malley, D. P., Jorgensen, J. L., Khoury, J. D., Bueso-Ramos, C. E., Orlowski, R. Z., Medeiros, L. J., & Young, K. H. (2016). Crystal-storing histiocytosis: A clinicopathological study of 13 cases. Histopathology, 68(4), 482-491. https://doi.org/10.1111/his.12768