Plasma Cell Neoplasms, Clinicopathological Characteristics and Immunophenotype of 21 Patients

Mónica Belinda Romero-Guadarrama, Cinthia Adriana Meza Medina, Elvira Aguilar Martínez

Facultad de Medicina, Universidad Autónoma de Nayarit, Tepic,, Mexico.
Unidad de Hematología del Hospital General de México, Mexico City, Mexico.
Unidad de Patología del Hospital General de México, Mexico City, Mexico.

DOI: 10.4236/ojpathology.2012.24023                

Abstract

Introduction: Plasma cell neoplasms are monoclonal proliferations characterized by the secretion of an immunoglobulin product known as component "M" or monoclonal. The World Health Organization (WHO 2008) defines as plasma cell neoplasms the following: plasma cell myeloma, plasmacytoma and those syndromes defined by immunoglobulin deposits and primary amyloidosis, The objective of the present work was to correlate their clinical, morphological and phenotype characteristics in 21 patients. Material and Methods: A 2-year retrospective review was performed of the files of the surgical pathology laboratory and of the hematology service of the General Hospital of Mexico, searching for patients with a diagnosis of plasma cell neoplasm. We analyzed the following variables: age, gender, clinical symptoms, evolution, localization, laboratory tests, morphology, and expression of immunohistochemical markers. Of the 21 patients, 12 (57.1%) corresponded to plasma cell myelomas and 9 (42.8%) were plasmacytomas (seven extraosseous and two solitary bone plasmacytoma); women predominated with 61.4% and age ranged between 22 and 84 years. Mass and epistaxis were observed in the patients with plasmacytomas, and symptoms of medullary compression and anemia were observed in those patients with plasma cell myeloma. The time of symptomatology varied from 3 to 12 months. Laboratory tests revealed that lactate dehydrogenase (LDH), beta 2 microglobulin, C-reactive protein were altered and that hypercalcemia and anemia were present more in the systemic form of the disease. Treatment depended on the clinical staging and laboratory data. Mature forms predominated morphologically. Immunohistochemical stain revealed a constant expression for CD 138, six patients expressed CD 56, and expression of the Kappa and Lambda light chains was while.

Keywords

Plasma Cell Neoplasms

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	S. H. Swerdlow, E. Campo, N. L. Harris, E. S. Jaffe, S. A. Pileri, H. Stein, J. Thiele and J. W. Vardiman, “WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues,” International Agency for Research on Cancer (IARC), Lyon, 2008.
[2]	S. Solly, “Remarks on the Pathology of Mollities Ossium: With Cases,” Medico-Chirurgical Transactions, Vol. 27, 1844, pp. 435-461.
[3]	H. B. Jones, “On a New Substance Occurring in the Urine of a Patient with Mollities and Fragilitas Ossium,” Philosophical Transactions of the Royal Society of London, Vol. 1, 1848, p. 673.
[4]	V. Rusitzky, “Multiples Myelom,” Dtsch Z Chir, Vol. 3, 1873, pp. 162-172.
[5]	R. Soutar, H. Lucraft, G. Jackson, et al., “Guidelines on the Diagnosis and Management of Solitary Plasmacytoma of Bone and Solitary Extramedullary Plasmacytoma,” British Journal of Haematology, Vol. 124, No. 6, 2004, pp. 717-726.
[6]	R. Tapia-Conyer, P. Kuri-Morales, C. Macías Martínez, et al., “Registro Histopatológico de Neoplasias en México,” 2012. http//www.dgepi.salud.go.mx/infoepi/Manual/Man18-Neoplasia/Man18.htm
[7]	R. P. Rizo, M. I. Sierra, P. G. Vázquez, et al., “Registro Hospitalario de Cáncer: Compendio de Cáncer 2000-2004,” Cancerología, Vol. 2, No. 3, 2007, pp. 203-287.
[8]	A. Jemal, R. Siegel, E. Ward, T. Murray, J. Xu and M. J. Thum, “Cancer Statistics,” Cancer Journal for Clinicians, Vol. 57, No. 1, 2007, pp. 43-66.
[9]	L. A. Ries, et al, Eds., “SEER Cancer Statistics Review 1975-2001,” National Cancer Institute, Bethesda, 2004.
[10]	Annon, “Criteria for the Classification of Monoclonal Gammopathies, Multiple Myeloma and Related Disorders: A Report of the International Myeloma Working Group,” British Journal of Haematology, Vol. 121, No. 5, 2003, pp. 749-757.
[11]	M. S. Linet, S. D. Harlow and J. K. McLaughlin, “A Case-Control Study of Multiple Myeloma in Whites; Chronic Antigenic Stimulation, Occupation and Drug Use,” Cancer Research, Vol. 47, No. 11, 1987, pp. 2978-2981.
[12]	J. Malpas, D. Bergsagel, R. Kyle and K. Anderson, Eds., “Myeloma, Biology and Management Saunders: Philadelphia,” 3rd Edition, 2004, pp. 121-143.
[13]	R. A. Kyle, M. A. Gertz, T. E. Witzig, J. A. Lust, M. Q. Lacy, A. Dispenzieri, R. Fonseca, et al., “Review of 1027 Patients with Newly Diagnosed Multiple Myeloma,” Mayo Clinic Proceedings, Vol. 78, No. 1, 2003, pp. 21-33.
[14]	E. E. C. Ceballos, J. E. C. Franco, J. R. E. Zamora and J. R. L. Méndez, “Oncologists Clinical of Iberoamerica. Hemato-Oncology. Part I,” Planeation and Development Editorial, S.A. of C.V., 2009, pp. 82-84.
[15]	V. H. J. Zepeda, V. J. Domínguez, “Plasma Cell Leukemia: A Rare Condition,” Annals of Hematology, Vol. 85, No. 4, 2006, pp. 263-267. doi:10.1007/s00277-005-0054-4
[16]	R. D. Brunning and R. W. McKenna, “Plasma Cell Dyscrasias and Related Disorders in: Atlas or Tumor Pathology,” Armed Forces Institute of Pathology, Washington, 1994.
[17]	P. Lin, R. Owens, G. Tricot and C. S. Wilson, “Flow Cytometric Immunophenotypic Analysis of 306 Cases of Multiple Myeloma,” American Journal of Clinical Pathology, Vol. 121, No. 4, 2004, pp. 482-488.
[18]	N. Sahara, A. Takeshita, K. Shigeno, S. Fujisawa, K. Takeshita, et al., “Clinicopathological and Prognostic Characteristics of CD56 Negative Multiple Myeloma,” British Journal of Hematology, Vol. 117, No. 4, 2002, pp. 882-885.
[19]	R. K?nigsberg, N. Zojer, J. Ackerman, E. Kr?mer, H. Kittler, E. Fritz, et al., “Predictive Role of Interphase Cytogenetics for Survival of Patients with Multiple Myeloma,” Journal of Clinical Oncology, Vol. 18, No. 4, 2000, pp. 804-812.
[20]	R. Fonseca, E. A. Blood, M. M. Oken, R. A. Kyle, G. W. Dewald, R. J. Bailey et al., “Myeloma and the t(11; 14) (q13; q32); Evidence for a Biologically Defined Unique Subset of Patients,” Blood, Vol. 99, No. 10, 2002, pp. 3735-3741.
[21]	J. D. Hoyer, C. A. Hanson, R. Fonseca, P. R. Greipp, G. Dewald and P. J. Kurtin, “The (11; 14) (q13; q32) Translocation in Multiple Myeloma,” American Journal of Clinical Pathology, Vol. 113, No. 6, 2000, pp. 831-837.
[22]	H. Chang, S. Samiee and Q. L. Yi, “Prognostic Relevance of CD56 Expression in Multiple Myeloma: A Study Including 107 Cases Treated with High-Dose Melphalan-Based Chemotherapy and Autologous Stem Cell Transplant,” Leukemia & Lymphoma, Vol. 47, No. 1, 2006, pp. 43-47. doi:10.1080/10428190500272549