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Plasma cells composing plasmacytoma have phenotypes different from those of myeloma cells
1Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan.
Abstract:
We describe one relapsed case of plasmacytoma of mandibular bone. The organs of relapse were liver and bone marrow. At relapse, monoclonal gammopathy (IgG-kappa) was observed without suppression of IgA and IgM. By immunostaining, the plasma cells of both the original mandibular bone and liver were positive for the same cytoplasmic immunoglobulin light chain kappa. The proliferative plasma cells in the bone marrow had the phenotype of CD38+, CD19+, and CD56- by flow cytometry and showed the presence of the rearranged IgH gene by Southern blotting. In addition, the zone of the Ig class of the patient's serum was not so sharply defined by zone electrophoresis. These results suggest that the characteristics of plasma cells of plasmacytoma are different from those of multiple myeloma.
Insights
This study details a relapsed mandibular plasmacytoma case with liver and bone marrow involvement. Findings suggest distinct plasma cell characteristics differentiate plasmacytoma from multiple myeloma.
Area of Science:
- Oncology
- Hematology
- Immunology
Background:
- Plasmacytoma is a plasma cell neoplasm, distinct from multiple myeloma.
- Understanding the cellular and molecular differences is crucial for diagnosis and treatment.
Observation:
- A case of relapsed mandibular plasmacytoma involving the liver and bone marrow is presented.
- Immunostaining confirmed identical kappa light chain expression in mandibular and liver plasma cells.
- Bone marrow plasma cells exhibited a CD38+, CD19+, CD56- phenotype with rearranged IgH genes.
Findings:
- Monoclonal gammopathy (IgG-kappa) was present at relapse without IgA and IgM suppression.
- Zone electrophoresis showed less defined immunoglobulin classes.
- Flow cytometry and Southern blotting characterized the proliferative plasma cells.
Implications:
- The distinct immunophenotype and genetic findings suggest plasmacytoma plasma cells differ from those in multiple myeloma.
- This case highlights the importance of detailed cellular analysis in differentiating plasma cell neoplasms.
- Further research into these differences may refine diagnostic criteria and therapeutic strategies.