Difference between revisions of "Plasma cell neoplasms"
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==Molecular== | ==Molecular== | ||
*t(4;14)(p16.3;q32.3) / IGH–MMSET.<ref name=pmid9787135>{{Cite journal | last1 = Chesi | first1 = M. | last2 = Nardini | first2 = E. | last3 = Lim | first3 = RS. | last4 = Smith | first4 = KD. | last5 = Kuehl | first5 = WM. | last6 = Bergsagel | first6 = PL. | title = The t(4;14) translocation in myeloma dysregulates both FGFR3 and a novel gene, MMSET, resulting in IgH/MMSET hybrid transcripts. | journal = Blood | volume = 92 | issue = 9 | pages = 3025-34 | month = Nov | year = 1998 | doi = | PMID = 9787135 }}</ref> | *t(4;14)(p16.3;q32.3) / IGH–MMSET.<ref name=pmid9787135>{{Cite journal | last1 = Chesi | first1 = M. | last2 = Nardini | first2 = E. | last3 = Lim | first3 = RS. | last4 = Smith | first4 = KD. | last5 = Kuehl | first5 = WM. | last6 = Bergsagel | first6 = PL. | title = The t(4;14) translocation in myeloma dysregulates both FGFR3 and a novel gene, MMSET, resulting in IgH/MMSET hybrid transcripts. | journal = Blood | volume = 92 | issue = 9 | pages = 3025-34 | month = Nov | year = 1998 | doi = | PMID = 9787135 }}</ref> | ||
** | **Associated with poor prognosis.<ref name=pmid12393535>{{Cite journal | last1 = Keats | first1 = JJ. | last2 = Reiman | first2 = T. | last3 = Maxwell | first3 = CA. | last4 = Taylor | first4 = BJ. | last5 = Larratt | first5 = LM. | last6 = Mant | first6 = MJ. | last7 = Belch | first7 = AR. | last8 = Pilarski | first8 = LM. | title = In multiple myeloma, t(4;14)(p16;q32) is an adverse prognostic factor irrespective of FGFR3 expression. | journal = Blood | volume = 101 | issue = 4 | pages = 1520-9 | month = Feb | year = 2003 | doi = 10.1182/blood-2002-06-1675 | PMID = 12393535 }}</ref> | ||
*13q deletion | *13q deletion. | ||
*17q deletion | **Worse prognosis.<ref name=Ref_PCPBoD8_324>{{Ref PCPBoD8|324}}</ref> | ||
*17q deletion. | |||
**Worse prognosis.<ref name=Ref_PCPBoD8_324>{{Ref PCPBoD8|324}}</ref> | |||
==See also== | ==See also== | ||
Revision as of 14:37, 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.
General
- Malignancy derived from the plasma cells.
- Prognosis: poor.
- Common primary bone tumour in adults.
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.
Multiple myeloma
Features of multiple myeloma (mnemonic CARL):
- Calcium (in the serum) is elevated.
- Anemia.
- Renal failure.
- Lytic bone lesions.
CRAB (calclium, renal failure, anemia, bony lesions) is another mnemonic.[2]
Microscopic
Features (plasmacytoma):
- 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.
- Usually with "clock face" morphology.
- Russell bodies:
- Eosinophilic, large (10-15 micrometres), homogenous immunoglobulin-containing inclusions.
- Dutcher bodies - intranuclear crystalline rods.
- Dutcher bodies are PAS stain +ve.[3]
- 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.
IHC
- Kappa -- usu. slightly stronger than lambda.
- Lambda.
- CD56.[4]
- Also +ve in NK/T cell lymphomas.
- CD57.
- Also +ve in T-cell large granular lymphocytic leukemia.[5].
- CD138.
- CD38. (???)
Molecular
- t(4;14)(p16.3;q32.3) / IGH–MMSET.[6]
- Associated with poor prognosis.[7]
- 13q deletion.
- Worse prognosis.[8]
- 17q deletion.
- Worse prognosis.[8]
See also
References
- ↑ 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.
- ↑ "Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group.". Br J Haematol 121 (5): 749-57. Jun 2003. PMID 12780789.
- ↑ 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.
- ↑ 8.0 8.1 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. 324. ISBN 978-1416054542.