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Published on: March 30, 2018
[Clinicopathologic features of lymphoplasmacytic lymphoma]
En-bin Liu1, Pei-hong Zhang, Zhan-qi Li
1Department of Pathology, Institute of Hematology and Hospital of Blood Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China.
Insights
Lymphoplasmacytic lymphoma (LPL) exhibits distinct clinicopathological features, with histological and immunohistochemistry crucial for diagnosis. Waldenström macroglobulinemia is a form of LPL.
Area of Science:
- Hematopathology
- Oncology
- Immunology
Background:
- Lymphoplasmacytic lymphoma (LPL) is a distinct B-cell malignancy.
- Understanding its clinicopathological features is essential for accurate diagnosis and management.
Purpose of the Study:
- To delineate the clinicopathological characteristics of lymphoplasmacytic lymphoma (LPL).
- To evaluate the utility of histology and immunohistochemistry in diagnosing LPL.
Main Methods:
- Analysis of 24 bone marrow biopsies and 6 lymph node specimens using routine histology and immunohistochemistry.
- Immunohistochemical staining for specific cell markers (Pax5, CD20, CD38, CD138, CD5, CD10, CD23, CyclinD1, CD3, CD7, MPO).
Main Results:
- The study included 24 patients, with a median age of 59.5 years and a male predominance (2.4:1).
- Common symptoms included weakness (83.3%), anemia (79.2%), and thrombocytopenia (37.5%).
- Histology revealed small lymphocytes, plasmacytoid lymphocytes, and plasma cells, with a predominantly diffuse pattern in bone marrow and lymph nodes. Immunohistochemistry confirmed expression of Pax5, CD20, CD38, and CD138, with negativity for other markers.
Conclusions:
- LPL presents with characteristic clinicopathological features.
- Histology and immunohistochemistry are vital for differentiating LPL from other small B-cell lymphomas.
- Waldenström macroglobulinemia is identified as LPL.
Objective:
To explore the clinicopathologic features of lymphoplasmacytic lymphomas (LPL).
Methods:
Routine histological examination was performed on hematoxylin-eosin stained sections of 24 bone marrow biopsies and available 6 concurrent lymph node specimens. Immunohistochemistry study was performed using EliVision methods.
Results:
Among 24 cases, the male-to-female ratio was 2.4:1 and the median age was 59.5 years (42 - 75). The most common symptom was weakness (83.3%, 20/24). Hyperviscosity and "B" symptoms occurred in 20.8% (5/24) and 8.3% (2/24) respectively. 41.7% (10/24) patients presented with lymphadenopathy. Anemia, leukocytosis and thrombocytopenia were seen in 79.2% (19/24), 8.3% (2/24) and 37.5% (9/24) respectively. Monoclonal Ig light chain expression was detected by serum immunofixation electrophoresis in 23 cases (95.8%), including IgM (20 cases), IgG (2 cases) and IgA (1 case). Basing on the histology and immunohistochemistry findings, the diagnosis was made in 22 bone marrow and 2 lymph node biopsies, respectively. Histologically, the bone marrow and lymph node specimens composed of small lymphocytes, plasmacytoid lymphocytes and plasma cells. The most frequent pattern of bone marrow involvement was diffuse in appearance (63.6%, 14/22), while nodular and interstitial patterns were less common (22.7%, 5/22 and 13.6%, 3/22, respectively). Lymph node involvement was also to be diffuse in pattern. The proliferative cells expressed Pax5, CD20, CD38 and CD138, but were negative for CD5, CD10, CD23, CyclinD1, CD3, CD7 and MPO.
Conclusions:
LPL has distinct clinicopathological features. Histological and immunohistochemistry findings are important for its differential diagnosis with chronic lymphocytic leukemia/small lymphocytic lymphoma, splenic marginal zone lymphoma and follicular lymphoma. Waldenström macroglobulinemia is LPL.
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