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IgM myeloma: case report with immunophenotypic profile

B Haghighi1, R Yanagihara, P J Cornbleet

  • 1Stanford University Medical Center, Department of Pathology, California 94305, USA. jcornbleet@pathology.standord.edu

American Journal of Hematology
|December 5, 1998
PubMed
Summary
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Immunoglobulin (Ig)M myeloma, a subtype of multiple myeloma (MM), exhibits a unique hybrid phenotype. This finding aids in distinguishing IgM myeloma from classic multiple myeloma and Waldenström

Area of Science:

  • Hematology
  • Immunology
  • Oncology

Background:

  • Multiple myeloma (MM) and Waldenström's macroglobulinemia (WM) are distinct B-cell malignancies.
  • Immunoglobulin (Ig)M myeloma presents features of both MM and WM.
  • The immunophenotypic profile of IgM myeloma has not been previously characterized.

Observation:

  • A case of IgM myeloma was analyzed using flow cytometry.
  • Cells displayed a hybrid phenotype, expressing plasma cell markers (CD38) and B-cell markers (CD20, FMC7, weak surface Ig).
  • Discordant B-cell antigen expression was noted, with absence of CD19 and CD22.

Findings:

  • IgM myeloma cells showed a unique surface antigen expression profile.
  • The phenotype included strong CD38 expression (plasma cell feature) and positive CD20, FMC7, and weak surface Ig (B-cell malignancy features).

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  • Absence of CD45, DR, CD19, CD22, CD23, CD10, and CD5 further defined the hybrid phenotype.

    • Implications:

    • This study characterizes the distinct immunophenotype of IgM myeloma.
    • The findings suggest IgM myeloma represents a unique entity with characteristics of both MM and WM.
    • Understanding this unique phenotype may improve diagnostic accuracy and guide therapeutic strategies.