Flame cells are seen in

Multiple myeloma usually presents as destructive plasma cell tumors (plasmacytomas) involving the axial skeleton. Relatively normal-appearing plasma cells, plasma blasts with vesicular nuclear chromatin and a prominent single nucleolus, or bizarre, multinucleated cells may predominate. Other cytologic variants stem from the dysregulated synthesis and secretion of Ig, which often leads to intracellular accumulation of intact or partially degraded protein. Such variants include flame cells with fiery red cytoplasm, Mott cells with multiple grapelike cytoplasmic droplets, and cells containing a variety of other inclusions, including fibrils, crystalline rods, and globules. The globular inclusions are referred to as Russell bodies (if cytoplasmic) or Dutcher bodies (if nuclear). In advanced disease, plasma cell infiltrates may be present in the spleen, liver, kidneys, lungs, lymph nodes, and other soft tissues.