CD5+ True SLL/CLL with Plasmacytic Differentiation and an Unusual 1p36 Translocation: Case Report and Review of the Literature

Evans, H. Lance; Polski, Jacek M.; Dunphy, Cherie H.

doi:10.3109/10428190009113393

Cited by 11 publications

(7 citation statements)

References 8 publications

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“…Indeed, many marginal zone lymphomas and virtually all lymphoplasmacytic lymphomas have a clonal PC component 7,8,21. Others, like diffuse large B-cell lymphomas,27,35 CLL/SLL9,14,17 and follicular lymphoma16,20 may show plasmacytic differentiation, while little is known about MCL 29,46. With the current study we provide strong evidence that clonal PCs differentiation can also occur in certain cases of MCL, clearly demonstrating that the PCs and MCL cells can derive from the same B-cell clone.…”

Section: Discussionmentioning

confidence: 99%

“…In lymphoplasmacytic lymphomas, the malignant clone shows a wide morphologic heterogeneity ranging from small B lymphocyte to PC, although little is known about its cell of origin 17. Among pre-GC deriving lymphomas, chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL)9,14,47 and MCL29,46 have also been described to occasionally show plasmacytic differentiation.…”

Section: Introductionmentioning

confidence: 99%

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Molecular Characteristics of Mantle Cell Lymphoma Presenting With Clonal Plasma Cell Component

Visco

Hoeller

Malik³

et al. 2011

American Journal of Surgical Pathology

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The normal counterparts of mantle cell lymphoma (MCL) are naïve quiescent B-cells that have not been processed through the germinal center (GC). For this reason, while lymphomas arising from GC or post-GC B-cells often exhibit plasmacytic differentiation, MCL rarely presents with plasmacytic features. Seven cases of MCL with a monotypic plasma cell (PC) population were collected from six centers and studied by immunohistochemistry, FICTION (Fluorescence immunophenotyping and Interphase Cytogenetics as a Tool for the Investigation of Neoplasms), capillary gel electrophoresis, and restriction fragment length polymorphism of immunoglobulin heavy chain analysis (RFLP/IgH) of microdissections of each of the MCL and PC populations to assess their clonal relationship. Clinical presentation was rather unusual compared to typical MCL, with two cases arising from extranodal soft-tissues of the head. All MCL cases were morphologically and immunohistochemically typical, bearing the t(11;14)(q13;q32). In all cases PC populations were clonal. In 5 of the 7 cases, the MCL and PC clones showed identical restriction fragments, indicating a common clonal origin of the neoplastic populations. The two cases with clonal diversity denoted the coexistence of two different tumors in a composite lymphoma/plasma cell neoplasm. Our findings suggest that MCL can present with a PC component that is often clonally related to the lymphoma, representing a rare but unique biological variant of this tumor.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Molecular Characteristics of Mantle Cell Lymphoma Presenting With Clonal Plasma Cell Component

Visco

Hoeller

Malik³

et al. 2011

American Journal of Surgical Pathology

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“…True plasmacytic differentiation in CLL appears to be very rare and may only be seen in the lymph node. 66 Clinical and radiographic findings, such as lytic bone lesions, hypercalcemia, non-IgM paraprotein, support a diagnosis of PCM because these features are very rare in the lymphoid malignancies discussed above (LPL, splenic MZL, and CLL). An erroneous diagnosis of mantle cell lymphoma is a critical diagnostic pitfall if it is not realized that the CD5 þ monoclonal B cells are separate from the cyclin D1þ plasma cells (Figure 3, D and F).…”

Section: Commentmentioning

confidence: 99%

Diagnostic and Clinical Considerations in Concomitant Bone Marrow Involvement by Plasma Cell Myeloma and Chronic Lymphocytic Leukemia/Monoclonal B-Cell Lymphocytosis: A Series of 15 Cases and Review of Literature

Alley

Wang

Dunphy

et al. 2013

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Plasma cell myeloma and chronic lymphocytic leukemia are both common hematologic malignancies, sharing many epidemiologic features. Concomitant detection of the 2 conditions poses special diagnostic challenges for the pathologist.Objective.-To describe the pathologic findings in cases of concomitant bone marrow involvement by myeloma and CD5þ monoclonal B cells and to outline the differential diagnostic possibilities, suggest a workup for correct diagnosis, and examine clinical outcome.Design.-Fifteen cases that met the diagnostic criteria were identified from pathology databases at 4 participating institutions. Morphologic findings were reviewed, additional immunohistochemical stains performed, and flow cytometric, cytogenetic, and relevant laboratory and clinical information was summarized. Previously published cases were searched from electronic databases and cross-references.Results.-Most patients (13 of 15) were older males. Often (11 of 15) they presented clinically with myeloma, yet had both monotypic plasma cells and B cells in the diagnostic marrow. In 4 patients, myeloma developed 24 months or later after chronic lymphocytic leukemia. In 7 patients, myeloma and CD5 þ B cells showed identical immunoglobulin light-chain restriction. Primary differential diagnoses include lymphoplasmacytic lymphoma, marginal zone lymphoma, and chronic lymphocytic leukemia with plasmacytoid differentiation. CD56 and/or cyclin D1 expression by plasma cells was helpful for correct diagnosis. Most patients in our cohort and published reports were treated for plasma cell myeloma.Conclusions.-Concomitant detection of myeloma and chronic lymphocytic leukemia in the bone marrow is a rare event, which must be carefully differentiated from lymphomas with lymphoplasmacytic differentiation for correct treatment.

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“…7 Plasmacytic differentiation is less commonly seen in other B-cell lymphomas, including small lymphocytic lymphoma (SLL) 8 and diffuse large Bcell lymphoma (DLBCL). 9 Occasionally, extensive plasmacytic differentiation in a B-cell lymphoma can make it difficult to distinguish it from a primary plasma cell (PC) dyscrasia, such as extraosseous plasmacytoma, especially when the diagnostic material is limited.…”

Section: Introductionmentioning

confidence: 99%

Immunophenotypic Differentiation Between Neoplastic Plasma Cells in Mature B-Cell Lymphoma vs Plasma Cell Myeloma

Seegmiller

McKenna

et al. 2007

Am J Clin Pathol

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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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CD5+ True SLL/CLL with Plasmacytic Differentiation and an Unusual 1p36 Translocation: Case Report and Review of the Literature

Cited by 11 publications

References 8 publications

Molecular Characteristics of Mantle Cell Lymphoma Presenting With Clonal Plasma Cell Component

Molecular Characteristics of Mantle Cell Lymphoma Presenting With Clonal Plasma Cell Component

Diagnostic and Clinical Considerations in Concomitant Bone Marrow Involvement by Plasma Cell Myeloma and Chronic Lymphocytic Leukemia/Monoclonal B-Cell Lymphocytosis: A Series of 15 Cases and Review of Literature

Immunophenotypic Differentiation Between Neoplastic Plasma Cells in Mature B-Cell Lymphoma vs Plasma Cell Myeloma

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