While not always statistically significant, certain features were more common in CVD than in the control group (Figure), including (1) abnormal bony trabeculae, (2) megaloblastoid changes in the erythroid lineage, (3) sea-blue histiocytes (SBHs), and (4) ALIP of the granulocytic lineage.
Sea-blue histiocytes, although relatively rare, have been reported in a variety of conditions ranging from the more commonly cited Niemann-Pick disease, to an effect of total parenteral nutrition including fat emulsions, to a variety of hematologic malignancies including non-Hodgkin lymphoma, light chain deposition disease, myeloproliferative neoplasms, and MDS.
C, Sea-blue histiocytes. D, Abnormal localization of immature precursors highlighted using a myeloperoxidase immunohistochemical stain.
Unusualpresentations of lymphoma: case 1, sea-blue histiocytes in non-Hodgkin's lymphoma.
Sea-blue histiocytes and Gaucher cells in bone marrow of patients with chronic myeloid leukaemia.
From this case study and others, we may conclude that apo E3[DELTA]149Leu causes a lipid-storage disease characterized by splenomegaly, splenic infiltration with foamy and sea-blue histiocytes
, and hypertriglyceridemia that may be unmasked following splenectomy.