IgM Lambda Globular Cytoplasmic Inclusions in Chronic Lymphocytic Leukaemia Resembling Immunocytoma

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Abstract
In a 64-yr-old woman with chronic lymphocytic leukemia [CLL], nearly 50% of the lymphocytes presented one or several globular intracytoplasmic inclusions, resembling Russell bodies, which were characterized by immunofluorescence as IgM .lambda.. On EM, the inclusions looked like cisternae of the rough endoplasmic reticulum. Surface membrane Ig was not detected and the serum IgM was low. Histology of a lymph node showed a lymphocytic proliferation with evidence of Ig synthesis, compatible with immunocytoma. The aggressive course of the disease necessitated polychemotherapy. This case represents an unusual, ill-defined lymphoproliferative disorder, lying between the B-CLL and a nonsecretory macroglobulinemia.