The illustrated bone marrow plasma cells (left and right) are from a 49-year-old woman with refractory anemia with multilineage dysplasia. They contain hemosiderin deposits. Since such deposits were first described in 1978 [1], there have been more than a dozen reports of such inclusions. They have been linked to iron overload (transfusional hemosiderosis, genetic hemochromatosis, myelodysplastic syndromes, congenital sideroblastic anemia) [2], copper deficiency [3], and bone marrow impairment caused by heavy alcohol intake [2, 4, 5]. Hemosiderin deposits in plasma cells have a deep-blue to greenish black color on a Romanowsky-type stain. Their nature can be confirmed by a Perls' Prussian blue stain. In the present patient, there was also increased macrophage iron but iron-laden plasma cells can occur in alcoholism without any necessity for there to be iron overload [5]. The detection of hemosiderin in plasma cells in this patient was the first indication of a previously unadmitted heavy alcohol intake.


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