In time a HCD may progress to a large cell B - immunoblastic lymphoma. Survival is variable from a few months to several years. No lytic bone lesions are present but plasmacytoid lymphocytes, plasma cells, eosinophils and histiocytes diffusely infiltrate the marrow and lymph nodes. As many as one third of g HCD patients have an associated autoimmune disease including AIHA, Sjogren's syndrome, rheumatoid arthritis, SLE, thyroiditis, etc. As with a HCD, survival in g HCD varies greatly from months to years.
Death is most often secondary to infection.
Marrow plasma cells are characteristically vacuolated. Hepatosplenomegaly is common as a presenting symptom, but without accompaning lymphadenopathy. Excess m chains are present in the peripheral blood and k light chains sometimes found in the urine. Amyloidosis Amyloidosis is a syndrome in which proteins with a b pleated sheet secondary structure accumulate in tissues. The b pleated sheet structure causes a green birefringence when Congo red stained material is polarized.