SOLITARY CRYSTAL-STORING HISTIOCYTOSIS OF THE TONGUE IN A PATIENT WITH RHEUMATOID-ARTHRITIS AND POLYCLONAL HYPERGAMMAGLOBULINEMIA

A 73-year-old woman with a long history of rheumatoid arthritis and po lyclonal hypergammaglobulinemia developed a solitary mass in the tongu e, which on morphologic and immunohistochemical analyses was consisten t with crystal-storing histiocytosis, a rare condition commonly descri bed in association with clonal lymphoplasmacytic disorders. The lesion consisted of a localized collection of histiocytes filled with numero us eosinophilic crystals immunoreactive for both kappa and lambda ligh t chain and gamma heavy chain antibodies. Mature lymphocytes and plasm a cells were present both throughout and around the lesion. Since a cl onal lymphoplasmacytic neoplasm was ruled out by clinical and immunohi stochemical studies, we consider that, in this case, crystal-storing h istiocytosis was consequent to polyclonal hypergammaglobulinemia and s uggest that this rare histiocytosis is not specific to lymphoplasmacyt ic neoplasms, but may represent a reaction to high values of normal (o r abnormal) immunoglobulins.