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Atypical lymphoplasmacytic and immunoblastic proliferation: A Systematic Review
Midori Filiz Nishimura1, Toshiaki Takahashi2, Kensuke Takaoka2
1Department of Molecular Hematopathology, Okayama University Graduate School of Health Sciences, Okayama, Japan.
Summary
Atypical lymphoplasmacytic and immunoblastic proliferation (ALPIBP) is often linked to autoimmune diseases but lacks clear definition. Increased awareness is crucial to prevent misdiagnosis of malignancy and unnecessary treatments.
Area of Science:
- Hematopathology
- Immunopathology
- Autoimmune Diseases
Background:
- Atypical lymphoplasmacytic and immunoblastic proliferation (ALPIBP) presents as lymph node findings in autoimmune diseases.
- ALPIBP lacks a clear definition despite its initial report in 1984.
- Distinguishing ALPIBP from malignancies is critical for appropriate patient management.
Approach:
- Systematic literature review of MEDLINE and EMBASE databases.
- Inclusion of 52 cases from 9 articles and 3 institutional cases for analysis.
- Summary of histological characteristics, clinical diagnoses, and treatment outcomes.
Key Points:
- The study analyzed 55 cases of ALPIBP, with a median age of 63.5 years and a female predominance (69.5%).
- Common associated autoimmune conditions include rheumatoid arthritis, SLE, and autoimmune hemolytic anemia.
- Differential diagnoses include T-follicular helper cell lymphoma, methotrexate-associated lymphoproliferative disorders, and IgG4-related diseases.
Conclusions:
- ALPIBP is characterized by specific histological findings often associated with autoimmune conditions.
- Underrecognition of ALPIBP can lead to overdiagnosis of hematological malignancy and unwarranted treatments.
- Enhanced awareness among pathologists and clinicians is essential for accurate diagnosis and management of ALPIBP.
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