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In Vitro Differentiation Model of Human Normal Memory B Cells to Long-lived Plasma Cells
Published on: January 20, 2019
Immunophenotypic differentiation between neoplastic plasma cells in mature B-cell lymphoma vs plasma cell myeloma
Adam C Seegmiller1, Yin Xu, Robert W McKenna
1Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9072, USA.
Insights
Differentiating non-Hodgkin lymphomas with plasmacytic features from myeloma is challenging. Immunophenotypic analysis reveals distinct markers, with CD19 and CD56 reliably distinguishing these plasma cell disorders.
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Non-Hodgkin lymphomas can exhibit significant plasmacytic differentiation, complicating differential diagnosis with plasma cell myeloma or plasmacytoma.
- Distinguishing these conditions can be difficult, particularly when diagnostic material is limited.
Purpose of the Study:
- To characterize the immunophenotypes of neoplastic plasma cells in B-lineage non-Hodgkin lymphoma.
- To compare these immunophenotypes with those observed in plasma cell myeloma.
- To identify reliable immunophenotypic markers for differentiating these plasma cell neoplasms.
Main Methods:
- Analysis of neoplastic plasma cell immunophenotypes in 41 cases of B-lineage non-Hodgkin lymphoma.
- Comparison of immunophenotypic data with cases of plasma cell myeloma.
- Evaluation of specific markers including CD19, CD45, surface immunoglobulin, and CD56.
Main Results:
- Plasma cells in non-Hodgkin lymphoma were more likely to express CD19, CD45, and surface immunoglobulin compared to plasma cells in myeloma.
- Plasma cells in lymphoma were less likely to express CD56 than those in myeloma.
- CD19 and CD56 expression demonstrated reliable utility in distinguishing between lymphoma and myeloma.
- Myeloma-associated lesions and solitary plasmacytomas showed myeloma-like immunophenotypes.
- Some extramedullary plasmacytomas exhibited lymphoma-like phenotypes, suggesting potential misclassification.
Conclusions:
- Immunophenotypic differences, particularly CD19 and CD56 expression, are valuable for distinguishing non-Hodgkin lymphomas with plasmacytic differentiation from plasma cell myeloma.
- Extramedullary plasmacytomas may represent a subset of non-Hodgkin lymphomas with extensive plasmacytic differentiation.
Abstract:
Some non-Hodgkin lymphomas show marked plasmacytic differentiation. In such cases, it may be difficult to differentiate these lymphoma from plasmacytoma or myeloma, especially with limited diagnostic material. However, there may be immunophenotypic differences in the plasma cells in these disorders that distinguish them. This study characterizes the immunophenotypes of neoplastic plasma cells in 41 cases of B-lineage non-Hodgkin lymphoma and compares them with those in plasma cell myeloma. We found that plasma cells in lymphoma were significantly more likely to express CD19, CD45, and surface immunoglobulin and less likely to express CD56 than those in myeloma. We further show that CD 19 and CD56 expression can be used reliably to distinguish these entities. Myeloma-associated osseous lesions and solitary plasmacytoma of bone showed myeloma-like immunophenotypes. However, some extramedullary plasmacytomas showed lymphoma-like phenotypes, suggesting that, in reality, they may represent non-Hodgkin lymphomas with extensive plasmacytic differentiation.
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