Difference between revisions of "Plasma cell neoplasms"

Revision as of 04:13, 1 August 2011

Plasma cell neoplasms arise from plasma cells. They are encountered by anatomical pathologists on occasion.

VL does not tease apart plasma cell myeloma, plasmacytoma and plasma cell neoplasm; the first two of these terms redirect to this article.

Clinical:^[1]

Bence Jones protein (urine).
Abnormal protein electrophoresis (monoclonal gammopathy, dysproteinemia, paraproteinemia).

Note:

Plasmacytoma = histology of multiple myeloma; to diagnose multiple myeloma other (non-pathology) criteria are needed.

Features:

Abundant eosinophilic cytoplasm.
Eccentrically placed nucleus.
- Usually with "clock face" morphology.
  - "Clock face" morphology = chromatin clumps around the edge of the nucleus, like the numbers on a clock face.
- May have nucleoli.
Russell bodies:
- Eosinophilic, large (10-15 micrometres), homogenous immunoglobulin-containing inclusions.
  - Images: Russell bodies (WC), Russell bodies (healthsystem.virginia.edu), Russell bodies - several in one cell (pathguy.com).
Dutcher bodies - intranuclear crystalline rods.
- Dutcher bodies are PAS stain +ve.^[2]
- Image Dutcher bodies (hematologylibrary.org).
Prominent perinuclear hof - cytoplasmic crescent shaped lucency adjacent to the nuclear membrane (due to large Golgi apparatus); nucleus has a "bib".

Images:

DDx:

Neuroendocrine carcinoma - nucleus often has a plasmacytoid (plasma cell-like) appearance.

↑ Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 323. ISBN 978-1416054542.
↑ URL: http://www.thefreelibrary.com/Dutcher+bodies+in+chronic+synovitis-a083551789. Accessed on: 4 August 2010.
↑ URL: http://www.ncbi.nlm.nih.gov/omim/116930. Accessed on: 31 August 2010.
↑ URL: http://www.nature.com/bmt/journal/v33/n1/full/1704298a.html. Accessed on: 31 August 2010.
↑ Chesi, M.; Nardini, E.; Lim, RS.; Smith, KD.; Kuehl, WM.; Bergsagel, PL. (Nov 1998). "The t(4;14) translocation in myeloma dysregulates both FGFR3 and a novel gene, MMSET, resulting in IgH/MMSET hybrid transcripts.". Blood 92 (9): 3025-34. PMID 9787135.
↑ Keats, JJ.; Reiman, T.; Maxwell, CA.; Taylor, BJ.; Larratt, LM.; Mant, MJ.; Belch, AR.; Pilarski, LM. (Feb 2003). "In multiple myeloma, t(4;14)(p16;q32) is an adverse prognostic factor irrespective of FGFR3 expression.". Blood 101 (4): 1520-9. doi:10.1182/blood-2002-06-1675. PMID 12393535.
↑ Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 317. ISBN 978-1416054542.