Difference between revisions of "Plasma cell neoplasms"

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Plasma cell neoplasms (view source)

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'''Plasma cell neoplasms''' arise from [[plasma cell]]s.  They are encountered by anatomical pathologists on occasion.
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Plasma cell neoplasm -- very high mag.jpg
| Width      =
| Caption    = Plasma cell neoplasm. [[H&E stain]]
| Synonyms  =
| Micro      = dyscohesive plasmacytoid cells (abundant cytoplasm, eccentrically placed nucleus), often prominent perinuclear hof, +/-nucleoli, +/-Russell bodies, +/-Dutcher bodies
| Subtypes  =
| LMDDx      = [[lymphoplasmacytic lymphoma]], [[neuroendocrine carcinoma]], poorly differentiated carcinoma, others
| Stains    =
| IHC        = [[CD138]] +ve, CD56 +ve, CD45 -ve/+ve, CD79a +ve
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[bone]] - [[bone marrow]]
| Assdx      = [[renal failure]], [[myeloma cast nephropathy]]
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence =
| Bloodwork  = +/-[[anemia]], +/-hypercalcemia
| Rads      = +/-lytic bone lesions
| Endoscopy  =
| Prognosis  = poor
| Other      =
| ClinDDx    = [[metastatic disease]]
| Tx        =
}}
'''Plasma cell neoplasms''' arise from [[plasma cell]]s.  They are encountered by anatomical pathologists on occasion.


[[VL]] does not tease apart ''plasma cell myeloma'', ''plasmacytoma'' (solitary myeloma)<ref name=Ref_PCPBoD8_324>{{Ref PCPBoD8|324}}</ref> and ''plasma cell neoplasm''; the first two of these terms redirect to this article.
''Plasma cell myeloma'', and ''plasmacytoma'' (solitary myeloma)<ref name=Ref_PCPBoD8_324>{{Ref PCPBoD8|324}}</ref> redirect to this article.


==General==
==General==
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Note:
Note:
*Plasmacytoma = histology of '''multiple myeloma'''; to diagnose ''multiple myeloma'' other (non-pathology) criteria are needed.
*Plasmacytoma = histology of '''multiple myeloma'''; to diagnose ''multiple myeloma'' other (non-pathology) criteria are needed.
Classified by site:
*Medullary.
*Extramedullary - usu. upper aerodigestive tract.<ref name=pmid10357398>{{Cite journal  | last1 = Alexiou | first1 = C. | last2 = Kau | first2 = RJ. | last3 = Dietzfelbinger | first3 = H. | last4 = Kremer | first4 = M. | last5 = Spiess | first5 = JC. | last6 = Schratzenstaller | first6 = B. | last7 = Arnold | first7 = W. | title = Extramedullary plasmacytoma: tumor occurrence and therapeutic concepts. | journal = Cancer | volume = 85 | issue = 11 | pages = 2305-14 | month = Jun | year = 1999 | doi =  | PMID = 10357398 }}</ref>


===Multiple myeloma===
===Multiple myeloma===
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*Russell bodies:
*Russell bodies:
**Eosinophilic, large (10-15 micrometres), homogenous immunoglobulin-containing inclusions.  
**Eosinophilic, large (10-15 micrometres), homogenous immunoglobulin-containing inclusions.  
***Images: [http://commons.wikimedia.org/wiki/File:Russell_bodies_2_high_mag_mini.jpg Russell bodies (WC)], [http://www.healthsystem.virginia.edu/internet/hematology/hessimages/russell-bodies-website-arrow.jpg Russell bodies (healthsystem.virginia.edu)], [http://www.pathguy.com/lectures/russ2.jpg Russell bodies - several in one cell (pathguy.com)].
*Dutcher bodies - intranuclear crystalline rods.
*Dutcher bodies - intranuclear crystalline rods.
**Dutcher bodies are ''PAS stain'' +ve.<ref>URL: [http://www.thefreelibrary.com/Dutcher+bodies+in+chronic+synovitis-a083551789 http://www.thefreelibrary.com/Dutcher+bodies+in+chronic+synovitis-a083551789]. Accessed on: 4 August 2010.</ref>
**Dutcher bodies are ''PAS stain'' +ve.<ref>URL: [http://www.thefreelibrary.com/Dutcher+bodies+in+chronic+synovitis-a083551789 http://www.thefreelibrary.com/Dutcher+bodies+in+chronic+synovitis-a083551789]. Accessed on: 4 August 2010.</ref>
**Image: [http://lh5.ggpht.com/--QNP_zV1j1E/SrpPM9rr2PI/AAAAAAAAA2s/ujrF4BYSBts/Dutcher-bodies-website-arrow.jpg Dutcher bodies (ggpht.com)].<ref>URL: [http://picasaweb.google.com/115272207060951660904/HistiocyteDisorders http://picasaweb.google.com/115272207060951660904/HistiocyteDisorders]. Accessed on: 10 August 2011.</ref>
*Prominent ''perinuclear hof'' - cytoplasmic crescent shaped lucency adjacent to the nuclear membrane (due to large Golgi apparatus); nucleus has a [http://en.wikipedia.org/wiki/Bib_%28garment%29 "bib"].
*Prominent ''perinuclear hof'' - cytoplasmic crescent shaped lucency adjacent to the nuclear membrane (due to large Golgi apparatus); nucleus has a [http://en.wikipedia.org/wiki/Bib_%28garment%29 "bib"].


Images:  
DDx:
*[[Neuroendocrine carcinoma]] - nucleus often has a plasmacytoid (plasma cell-like) appearance.
<!-- [http://ashimagebank.hematologylibrary.org/cgi/content/full/2003/0227/100629 Dutcher bodies (hematologylibrary.org)]. -->
*[[Lymphoplasmacytic lymphoma]] ([[AKA]] Waldenström's macroglobulinemia).
*[[Syphilis]].
 
===Images===
=====Case=====
<gallery>
Image: Plasma cell neoplasm -- low mag.jpg | PCN - low mag.
Image: Plasma cell neoplasm -- intermed mag.jpg | PCN - intermed. mag.
Image: Plasma cell neoplasm -- high mag.jpg | PCN - high mag.
Image: Plasma cell neoplasm -- very high mag.jpg | PCN - very high mag.
</gallery>
=====Other cases=====
<gallery>
Image:Plasmacytoma1.jpg | Plasmacytoma. (WC)
File:Plasmocytoma HE high mag.jpg | Skull base plasmacytoma, higher magnification (WC/jensflorian)
File:Plasmocytoma_frozen_HE_x200.jpg | Plasmacytoma smear (WC/jensflorian)
File:Plasmocytoma_smear_mann_x200.jpg | Leptomeningeal plasmacytoma, frozen section (WC/jensflorian)
</gallery>
=====www=====
*[http://ashimagebank.hematologylibrary.org/cgi/content/full/2004/0126/100984 Various images (hematologylibrary.org)].
*[http://ashimagebank.hematologylibrary.org/cgi/content/full/2004/0126/100984 Various images (hematologylibrary.org)].
*[http://commons.wikimedia.org/wiki/File:Plasmacytoma1.jpg Plasmacytoma (WC)].
*[http://path.upmc.edu/cases/case515/images/fig05.jpg Multiple myeloma (upmc.edu)].<ref>URL: [http://path.upmc.edu/cases/case515.html http://path.upmc.edu/cases/case515.html]. Accessed on: 25 January 2012.</ref>
*[http://path.upmc.edu/cases/case515/images/fig05.jpg Multiple myeloma (upmc.edu)].<ref>URL: [http://path.upmc.edu/cases/case515.html http://path.upmc.edu/cases/case515.html]. Accessed on: 25 January 2012.</ref>


DDx:
====Russell bodies====
*[[Neuroendocrine carcinoma]] - nucleus often has a plasmacytoid (plasma cell-like) appearance.
<gallery>
<!-- [http://ashimagebank.hematologylibrary.org/cgi/content/full/2003/0227/100629 Dutcher bodies (hematologylibrary.org)]. -->
Image:Russell_bodies_2_high_mag_mini.jpg | Russell bodies. (WC)
</gallery>
=====www=====
*[http://www.healthsystem.virginia.edu/internet/hematology/hessimages/russell-bodies-website-arrow.jpg Russell bodies (healthsystem.virginia.edu)].
*[http://www.pathguy.com/lectures/russ2.jpg Russell bodies - several in one cell (pathguy.com)].
 
====Dutcher bodies====
<gallery>
Image: Dutcher and Russell bodies.jpg | Dutcher bodies and Russell bodies. (WC/Gabriel Caponetti)
</gallery>


==IHC==
==IHC==
*[[CD138]] +ve.
*[[CD56]] +ve.<ref>URL: [http://www.ncbi.nlm.nih.gov/omim/116930 http://www.ncbi.nlm.nih.gov/omim/116930]. Accessed on: 31 August 2010.</ref>
**Also +ve in NK/T cell lymphomas.
*Kappa -- usu. slightly stronger than lambda.
*Kappa -- usu. slightly stronger than lambda.
*Lambda.
*Lambda.
*CD56.<ref>URL: [http://www.ncbi.nlm.nih.gov/omim/116930 http://www.ncbi.nlm.nih.gov/omim/116930]. Accessed on: 31 August 2010.</ref>
**Also +ve in NK/T cell lymphomas.
*CD57.  
*CD57.  
**Also +ve in [[T-cell large granular lymphocytic leukemia]].<ref>URL: [http://www.nature.com/bmt/journal/v33/n1/full/1704298a.html http://www.nature.com/bmt/journal/v33/n1/full/1704298a.html]. Accessed on: 31 August 2010.</ref>
**Also +ve in [[T-cell large granular lymphocytic leukemia]].<ref>URL: [http://www.nature.com/bmt/journal/v33/n1/full/1704298a.html http://www.nature.com/bmt/journal/v33/n1/full/1704298a.html]. Accessed on: 31 August 2010.</ref>
*CD138.
*CD38 +ve.<ref>{{Cite journal  | last1 = Tamamori | first1 = T. | last2 = Nakayama | first2 = F. | last3 = Sugimoto | first3 = H. | last4 = Fenxiang | first4 = J. | last5 = Iwatsuki | first5 = K. | last6 = Takigawa | first6 = M. | title = Extramedullary plasmacytoma: cytological and genotypic studies. | journal = Br J Dermatol | volume = 129 | issue = 4 | pages = 468-72 | month = Oct | year = 1993 | doi =  | PMID = 8217765 }}</ref>
*CD38. (???)
 
Others:<ref>URL: [http://e-immunohistochemistry.info/web/Plasmacytoma_plasma_cell_myeloma.htm http://e-immunohistochemistry.info/web/Plasmacytoma_plasma_cell_myeloma.htm]. Accessed on: 9 November 2015.</ref>
*CD79a +ve.
*CD45 -ve/+ve.
*CD10 -ve.
*CD5 -ve.
*Cyclin D1 -ve/+ve.
 
A panel:<!-- need a good panel - maybe here http://clincancerres.aacrjournals.org/content/15/2/714.full or here http://e-immunohistochemistry.info/web/Plasmacytoma_plasma_cell_myeloma.htm -->
*CD3, CD20, CD56, CD117, CD138, IG-kappa (plasma), IG-lambda (plasma).


==Molecular==
==Molecular==
Michael
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