scholarly journals A Rare Case of Plasma Cell Granuloma

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Archana P. Kanteti ◽  
W. Patrick Kelsey ◽  
Ernesto Martinez Duarte
Keyword(s):  
Plasma Cell ◽  
Plasma Cells ◽  
Careful Examination ◽  
Therapeutic Approaches ◽  
Elderly Male ◽  
Plasma Cell Neoplasms ◽  
Choice Of Treatment ◽  
Inflammatory Pseudotumors ◽  
Proper Diagnosis ◽  
Rule Out

Plasma cell granulomas (PCGs) or inflammatory pseudotumors are nonneoplastic lesions that consist of predominantly antibody-secreting plasma cells and innate immune cells such as neutrophils, macrophages, and eosinophils. Unlike in multiple myeloma, the plasma cells are polyclonal and present in a spindly fibroblast-rich stromal background. These lesions mainly occur in the lungs; however, they can arise in other organs. PCGs from the gingiva are extremely rare, and a proper diagnosis is crucial to treat these patients further. These tumors have an increased number of plasma cells that are immunoreactive with CD138 and are polyclonal for kappa and lambda light chains, confirming these proliferations’ nonneoplastic nature. Surgical resection with clear margins, when possible, is the primary choice of treatment. Radiation and anti-inflammatory steroid therapy are other therapeutic approaches. Critical and careful examination by a pathologist is necessary to rule out plasma cell neoplasms. Here, we report a rare occurrence of gingival PCG in an elderly male.

Should CD138 Immunohistochemistry be Standard Recommended Practice for Bone Marrow Evaluation of Plasma Cell Neoplasms?

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S110-S110
Author(s):  
A Vijayanarayanan ◽  
K Inamdar ◽  
M Menon ◽  
P Kuriakose
Keyword(s):  
Bone Marrow ◽  
Plasma Cell ◽  
Linear Correlation ◽  
Plasma Cells ◽  
Pearson Correlation ◽  
Protein Electrophoresis ◽  
Pearson Correlation Coefficient ◽  
Cell Percentage ◽  
Significant Linear Correlation ◽  
Plasma Cell Neoplasms

Abstract Introduction/Objective Myeloma diagnosis by a pathologist requires 10% plasma cells (PC) or a biopsy proven plasmacytoma in addition to myeloma defining events. PC% > 60% is a biomarker of malignancy under this definition. WHO allows for assesment of plasma cell percentage either by aspirate count or by CD138 immunohistochemistry (IHC). There is lack of consensus on aspirate smear adequacy for PC% estimation. Uneven distribution of plasma cells, hemodilution and/or patchy infiltration can lead to gross underestimation. We compared PC% by aspirate count and CD138 IHC and established corelation with serum protein electrophoresis (SPEP) values. Methods 67 myeloma cases were included after excluding cases with suboptimal or inadequate aspirate smears. Two hematopathologists evaluated the diagnostic marrow (therapy naive) for PC% by aspirate count and CD138 IHC on biopsy/clot section. Corresponding SPEP and Free light chain (FLC) values were obtained. Correlation coefficent was calculated using Pearson correlation coefficient (GraphPad Prism). Results The Ig subtypes included IgG (41/67) and IgA (17/67). 12 cases had available FLC values. Both average and median PC% by CD138 IHC was considerably higher (50%, 52%) compared to aspirate count (29%, 21%). However, PC% by aspirate smear count and CD138 IHC demonstrated a significant linear correlation (r=0.71, p60% by CD138 (and not by aspirate count). Conclusion CD138 IHC based PC% is consistently higher, nevertheless, statistically significant linear corelation is observed between aspirate count PC% and CD138 IHC. A significant linear correlation is observed between CD138 IHC and SPEP (IgG and IgA), however, no such correlation is observed with aspirate count. More cases were diagnosed as myeloma (11%) and higher propotion of cases (35%) had biomarker of malignancy i.e. PC% >60% by CD138 IHC. Based on these findings, we propose estimation of PC% by CD138 immunostain be a recommended standard practice for better clinicopathologic and biologic correlation.

Cutaneous Plasmacytosis: A Pitfall For B and Plasma Cell Neoplasms

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S98-S98
Author(s):  
C N Giraldo ◽  
D Myers ◽  
A Holmes ◽  
J Dodd ◽  
W Wendi
Keyword(s):  
Plasma Cell ◽  
Plasma Cells ◽  
Plasma Cell Dyscrasia ◽  
Topical Steroids ◽  
Cell Infiltrate ◽  
Systemic Involvement ◽  
Topical Tacrolimus ◽  
Plasma Cell Neoplasm ◽  
Plasma Cell Neoplasms ◽  
Intralesional Steroid

Abstract Introduction/Objective Cutaneous plasmacytosis (CP) is an uncommon condition typically affecting Asian males in the 3rd to 5th decades. It is thought to be a reactive process that classically presents with asymptomatic, red-brown, plaques and nodules on the face and neck. It has been associated with polyclonal hypergammaglobulinemia and systemic involvement. Histologically it is characterized by dense superficial and deep dermal infiltrates of mature plasma cells with polyclonal differentiation on in-situ hybridization (ISH). The differential diagnosis includes neoplastic plasma cell processes, characteristically with monoclonal plasma cell infiltrate, and mature B cell neoplasms with polyclonal plasma cell differentiation. Methods We report a case of a 69 year old Caucasian male who presented with asymptomatic, enlarging red-brown nodules on bilateral nasal ala. Histologic examination revealed dense, superficial plasma cell infiltrate, concerning for a plasma cell neoplasm. CD138 and Kappa/Lambda ISH demonstrated plasma cell polyclonality. Further workup ruled out infectious or systemic involvement and a plasma cell dyscrasia was ruled out by Hematology/Oncology. Results These findings supported the diagnosis of CP. Treatment with intralesional steroids showed initial improvement with regrowth of the nodules. To date, treatment with topical steroids and CO2 laser ablation are being considered. Conclusion CP is reported as type of pseudolymphoma, which is described as a reactive lymphoproliferation that histopathologically and/or clinically imitates cutaneous lymphoma. The pathogenesis is unknown, however, there are studies suggesting an association with increased interleukin-6, which is involved in the differentiation of B cells to mature plasma cells. The majority of patients with CP have a favorable prognosis. There has been variable success with both topical and intralesional treatment to include, cyclophosphamide, topical tacrolimus, prednisone, intralesional steroid therapy, topical psoralens combined with ultraviolet A exposure, and other chemotherapies. Familiarity with this rare entity is imperative to prevent misdiagnosis and overtreatment.

scholarly journals Extramedullary plasmacytoma of the tongue: A case report

2021 ◽  
Vol 2 (6) ◽  
Author(s):  
Leart Berdica ◽  
◽  
Teona Bushati ◽  
Alfred Aga ◽  
Emirjona Vajushi ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Differential Diagnosis ◽  
Plasma Cell ◽  
Plasma Cells ◽  
Histopathological Examination ◽  
English Literature ◽  
Extramedullary Plasmacytoma ◽  
Imaging Data ◽  
Plasma Cell Neoplasms ◽  
Extramedullary Plasmocytoma

Background: Tongue extramedullary plasmacytoma is a very rare pathology. Despite rare cases, extramedullary plasmacytoma should be considered as a differential diagnosis in case of a mass in the tongue. A total of 19 cases were reported with EMP in English literature along with the case we will address. It is characterized by a monoclonal neoplastic proliferation of plasma cells in the absence of multiple myeloma (MM). Histopathology and immunohistochemistry are very important for the diagnosis and differential diagnosis. Case presentation: The case we will describe is an 80-year-old lady from Albania who presents with a vegetative lesion in the form of a thick plate on the dorsal part of the tongue with dimensions 6 X 5 X 1.5 cm. A material of 0.5 cm diameter was taken from the lesion for the biopsy. After histopathological examination, immunohistochemical examinations, and after correlations with laboratory, clinical and imaging data, the diagnosis of extramedullary plasmacytoma of the tongue was reached. The patient underwent radiotherapy treatment. Conclusions: EMP is a rare tumor, accounting for 3% of plasma cell neoplasms and <1% of all head and neck tumors. The diagnosis of EMP, in this case, was reached with biopsy, immunohistochemistry, and the correlation with laboratory and imaging data. We will show the importance of biopsy along with immunohistochemistry in the diagnosis and differential diagnosis of extramedullary plasmocytoma of the tongue. Keywords: plasmacytoma; immunohistochemistry; biopsy; plasma cell. Abbreviations: EMP: Extramedullary plasmacytoma; MM: Multiple myeloma; Cm: centimeter

scholarly journals Detection of Circulating Tumor Plasma Cells in Monoclonal Gammopathies: Methods, Pathogenic Role, and Clinical Implications

Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1499
Author(s):  
Luzalba Sanoja-Flores ◽  
Juan Flores-Montero ◽  
Martín Pérez-Andrés ◽  
Noemí Puig ◽  
Alberto Orfao
Keyword(s):  
Solid Tumors ◽  
Tumor Cells ◽  
Plasma Cell ◽  
Hematological Malignancies ◽  
Plasma Cells ◽  
Low Frequency ◽  
Strong Impact ◽  
Monoclonal Gammopathies ◽  
Plasma Cell Neoplasms ◽  
Cancer Dissemination

Cancer dissemination and distant metastasis most frequently require the release of tumor cells into the blood circulation, both in solid tumors and most hematological malignancies, including plasma cell neoplasms. However, detection of blood circulating tumor cells in solid tumors and some hematological malignancies, such as the majority of mature/peripheral B-cell lymphomas and monoclonal gammopathies, has long been a challenge due to their very low frequency. In recent years, the availability of highly-sensitive and standardized methods for the detection of circulating tumor plasma cells (CTPC) in monoclonal gammopathies, e.g., next-generation flow cytometry (NGF), demonstrated the systematic presence of CTPC in blood in virtually every smoldering (SMM) and symptomatic multiple myeloma (MM) patient studied at diagnosis, and in the majority of patients with newly-diagnosed monoclonal gammopathies of undetermined significance (MGUS). These methods set the basis for further detailed characterization of CTPC vs. their bone marrow counterpart in monoclonal gammopathies, to investigate their role in the biology of the disease, and to confirm their strong impact on patient outcome when measured both at diagnosis and after initiating therapy. Here, we review the currently available techniques for the detection of CTPC, and determine their biological features, physiopathological role and clinical significance in patients diagnosed with distinct diagnostic categories of plasma cell neoplasms.

scholarly journals Interleukin-4 inhibits growth of multiple myelomas by suppressing interleukin-6 expression

Blood ◽  
1991 ◽  
Vol 78 (8) ◽  
pp. 2070-2074 ◽  
Author(s):  
F Herrmann ◽  
M Andreeff ◽  
HJ Gruss ◽  
MA Brach ◽  
M Lubbert ◽  
...  
Keyword(s):  
Plasma Cell ◽  
Plasma Cells ◽  
Quantitative Polymerase Chain Reaction ◽  
Interleukin 4 ◽  
Chain Reaction ◽  
Plasma Cell Neoplasms ◽  
Dose Dependent Fashion ◽  
Polymerase Chain ◽  
Multiple Myelomas ◽  
Dose Dependent

Unfractionated bone marrow (BM) cells obtained from patients with multiple myeloma (MM) exhibit high levels of interleukin (IL)-6. Secretion of IL-6 by these cells as well as spontaneous plasma cell proliferation can be abrogated by neutralizing anti-IL-6 monoclonal antibody (MoAb). Treatment of BM cells with recombinant human (rh)IL-4 at doses of 50 to 250 U/mL blocked endogenous IL-6 synthesis in a dose- dependent fashion and was associated with significant reduction of plasma cell growth that could be reversed by exogenous rhIL-6. Enrichment of BM cells from MM patients for plasma cells and adherent cells and analysis of IL-6 mRNA in these subpopulations by means of quantitative polymerase chain reaction (PCR) showed that adherent BM cells accounted for most of the synthesis of IL-6 transcripts, whereas plasma cells displayed negligible levels of IL-6 mRNA only. These results suggest therapeutic evaluation of rhIL-4 in patients with plasma cell neoplasms.

scholarly journals BRAF V600E Positive Hairy Plasma Cell Leukemia; Are the Cytoplasmic Projections in Plasma Cells Predictive of a Particular Molecular Characterization?

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Elham Jamali ◽  
Ehsan Sarraf Kazerooni ◽  
Akbar Hashemi Tayer ◽  
Reza Ranjbaran
Keyword(s):  
Plasma Cell ◽  
Braf Mutation ◽  
Plasma Cells ◽  
Lymphoid Cells ◽  
Plasma Cell Leukemia ◽  
Braf V600e ◽  
Plasma Cell Dyscrasia ◽  
Cell Leukemia ◽  
Braf Mutations ◽  
Plasma Cell Neoplasms

Introduction: Plasma cell leukemia (PCL) is a rare and clinically aggressive form of plasma cell dyscrasia. Despite the significant role of BRAF mutation in plasma cell neoplasms, this mutation has been rarely considered in these cases. Finding evidence guiding us toward assessing the BRAF mutation in patients with plasma cell neoplasms could help make the suitable decision for targeted therapy. Case Presentation: A 79-year-old man presented with leukocytosis. Peripheral blood smear exhibited marked lymphocytosis and infiltration of about 50% abnormal lymphoid cells with slender cell-surface projections and oval shape nucleus. These findings raised the provisional diagnosis of hairy cell leukemia (HCL) or HCL variants (HCL-v). Molecular analysis confirmed the presence of BRAFV600E mutation, which was in agreement with HCL diagnosis, albeit the flow cytometric assessment of abnormal lymphocytes corroborated PCL. Conclusions: Together with the previous comprehensive analysis regarding the association of cytoplasmic projections and BRAF mutations, our findings could suggest this morphological characteristic in plasma cells (PCs) as an indication for the assessment of BRAF V600E mutation in PC dyscrasias.

scholarly journals Aberrant acquisition of T-cell associated markers in plasma cell neoplasms: An aggressive disease with extramedullary involvement and very short survival

2021 ◽  
Vol 13 (1) ◽  
pp. e2021043
Author(s):  
Dina Sameh Soliman ◽  
Hesham Elsabah ◽  
Ibrahim Ganwo ◽  
Aliaa Amer ◽  
Ruba Y Taha ◽  
...  
Keyword(s):  
T Cell ◽  
Plasma Cell ◽  
Plasma Cells ◽  
Published Data ◽  
Extensive Literature ◽  
Clinicopathologic Characteristics ◽  
Aberrant Expression ◽  
Short Survival ◽  
Cell Markers ◽  
Plasma Cell Neoplasms

Background: Plasma cell neoplasms can show aberrant expression of a different lineage-related antigens, however, co-expression of T-cell associated markers on malignant plasma cells is extremely rare. Material and methods: This is a report of clinicopathologic characteristics of three myeloma patients with emergent plasmablastic morphology and aberrant acquisition of T‐cell associated markers. An extensive literature search for similar cases was conducted and the relevant pathologic, clinical and prognostic characteristics were summarized. Results: A total of 22 cases of plasma cell neoplasm, showed aberrant co-expression of T-cell markers. We found an evident association between aberrant expression of T-cell markers on malignant plasma cells and extramedullary involvement, aggressive morphologic features, high proliferative index ki67 >90%, aggressive clinical course, adverse outcome with short survival. Conclusion: Due to rarity of this aberrant phenotype and scarcity of the published data, the precise causative mechanism and its clinical implications have not yet been elucidated.

scholarly journals Plasma Cell Enrichment Enhances Detection of High-Risk Cytogenomic Abnormalities by Fluorescence In Situ Hybridization and Improves Risk Stratification of Patients With Plasma Cell Neoplasms

2013 ◽  
Vol 137 (5) ◽  
pp. 625-631 ◽  
Author(s):  
Gary Lu ◽  
Ramya Muddasani ◽  
Robert Z. Orlowski ◽  
Lynne V. Abruzzo ◽  
Muzaffar H. Qazilbash ◽  
...  
Keyword(s):  
In Situ Hybridization ◽  
High Risk ◽  
Risk Stratification ◽  
Fluorescence In Situ Hybridization ◽  
Plasma Cell ◽  
Plasma Cells ◽  
Cell Enrichment ◽  
Plasma Cell Neoplasms

Context.—Methods for plasma cell enrichment of bone marrow (BM) specimens can increase the sensitivity of fluorescence in situ hybridization (FISH) for detecting cytogenomic abnormalities. There are no published reports using these methods to evaluate high-risk cytogenomic abnormalities in patients with plasma cell neoplasms (PCNs) after therapy. Objective.—To evaluate the utility of plasma cell enrichment combined with FISH for detection of high-risk cytogenomic abnormalities in patients with PCNs after therapy. Design.—Twenty-eight patients with PCNs, of whom 22 received treatment, were included in this study. Plasma cells were enriched in BM aspirates by using a magnetic cell-sorting procedure to select CD138+ cells. Probes were chosen to assess for del(17p13/TP53), del(13q14/RB1), 1q21/CKS1B gain, IgH/FGFR3, and IgH/MAF. Clinicopathologic data were collected during clinical follow-up after plasma cell enrichment. Results.—Plasma cells in nonenriched BM specimens ranged from 1% to 28% (median, 8%) compared with 28% to 96% (median, 73%) in enriched BM specimens (P &lt; .001). In a subset of treated patients in clinical remission, FISH detected high-risk cytogenomic abnormalities only in plasma cell–enriched samples. This approach also detected abnormalities in cases of solitary plasmacytoma and monoclonal gammopathy of undetermined significance. Conclusions.—Plasma cell enrichment of BM specimens increases FISH sensitivity for detecting high-risk cytogenomic abnormalities, particularly in treated patients, and these results, in combination with clinical follow-up data, can be of value to improve risk stratification and patient management.

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