Extramedullary multiple myeloma. A qualitative and quantitative electron microscopic study.

A case of multiple myeloma with a mediastinal tumor and other unusual findings is described. The findings included the presence of extramedullary tumor masses at multiple sites in addition to the medullary tumor and, more interestingly, the occurrence of pleural and peritoneal effusions. The plasma cells from these effusions were analyzed using stereological morphometric methods. The plasma cells were also cultured and established as a continuous cell line and were studied using the same methods. Our results indicate that there are qualitative and quantitative morphologic differences between the pleural and peritoneal plasma cells. Comparison between plasma cells and cultured cells from the intraperitoneal exudate showed marked morphologic differences. The analysis of these differences indicated that mature plasma cells, when subjected to culture, were transformed into immature lymphoid cells.