H. Usuda et al., CRYSTALGLOBULIN-INDUCED VASCULOPATHY ACCOMPANYING ISCHEMIC INTESTINALLESIONS OF A PATIENT WITH MYELOMA, Pathology international, 46(2), 1996, pp. 165-170
A 37 year old man with multiple myeloma (IgG lambda) developed perfora
tion of the small intestine and had gangrene in his feet. In the resec
ted small intestine and below-knee amputated feet, intravascular depos
ition of crystals, immunohistochemically positive for IgG and a lambda
light chain, were found. Although paraproteins produced in the course
of plasma cell dyscrasia may crystallize and cause systemic occlusive
vasculopathy, this is the first case with intestinal involvement. Bec
ause cryoglobulinemia was absent in this patient, crystals may be deri
ved from the myeloma protein which sometimes crystallizes in the blood
without the influence of low temperature.