IgM multiple myeloma: More on a rare and heterogeneous disease

Cabrera, Quentin; Chantepie, Sylvain; Salaün, Véronique; Levaltier, Xavier; Troussard, Xavier; Macro, Margaret

doi:10.1002/ajh.22067

Cited by 5 publications

(4 citation statements)

References 7 publications

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“…5,7,10,12,14,15 In keeping with these previous reports, 11 (73%) of the 15 IgM MM cases were cyclin D1 positive. In all positive cases, there was both nuclear and cytoplasmic cyclin D1 staining.…”

Section: Resultssupporting

confidence: 88%

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IgM Multiple Myeloma

King

Howard

Hodnefield

2013

American Journal of Clinical Pathology

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The frequent B-cell-associated antigen expression by IgM MM distinguishes it from other MM types, causing significant pathologic overlap with lymphoplasmacytic lymphoma (LPL). However, IgM MM is usually distinguished from LPL by aberrant cyclin D1 expression or t(11;14). Therefore, assessing for these abnormalities is recommended when evaluating bone marrow involvement by IgM-associated lymphoplasmacytoid disorders.

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Section: Resultssupporting

confidence: 88%

“…4 Literature on the bone marrow pathology of IgM MM is limited and difficult to interpret, however, due to the paucity of cases and the varying inclusion criteria used. 5,6 For this reason, attributes that may be unique to this MM subtype and/or may aid in making the important and difficult distinction from LPL remain incompletely understood.…”

mentioning

confidence: 99%

IgM Multiple Myeloma

King

Howard

Hodnefield

2013

American Journal of Clinical Pathology

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“…The translocation t(11;14) (q13;q32) has an occurrence rate of 15–18% and is associated with a significantly higher positive rate of B‐linage associated antigens CD20 and CD79a as well as the lack of CD56 . The t(11;14), resulting in an aberrant cyclin D1 expression, is well documented in a subset of MM, often with lymphoplasmacytic cytology, and has been enriched among IgM, inmunoglobulin E and nonsecretory variants .…”

Section: Discussionmentioning

confidence: 99%

Atypical IgM multiple myeloma with deletion of c‐MAF

Salcedo

Rubio

Fernández

et al. 2015

Int J Lab Hematology

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IgM multiple myeloma (MM) is a rare subtype of myeloma that shares clinical and pathological features with Waldenström's macroglobulinaemia. These are two separate entities that differ both in therapy and prognosis. We report a 57-year-old male, who presented with anaemia, hypercalcaemia, acute renal failure and several vertebral fractures that clinically suggested a multiple myeloma. Further investigations revealed a serum monoclonal component of IgM lambda type and a bone marrow infiltrated by small, lymphoplasmocytic cells. IgM MM was finally diagnosed by means of both inmunophenotypic and immunohistochemistry techniques, stressing the importance of inmunophenotypic evaluation when clinical and morphological features are discordant. Fluorescence in situ hybridization (FISH) studies disclosed a particular combination of deletion 13q14, t(11;14) and monoallelic deletion C-MAF without t(14;16). The clinical evolution after a Bortezomib-containing polychemotherapy and autologous stem cell transplantation (ASCT) conditioned with busulphan and melphalan is also presented. This very uncommon case highlights the impact of immunophenotyping on the differential diagnosis between IgM MM and WM, to choose the best treatment and establish an appropriate outcome.

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“…These findings are inconsistent with plasma cell myeloma. Furthermore, the immunophenotypic positivity for IgM and CD56 seen in our case made a diagnosis of plasma cell myeloma much less likely, because an IgM myeloma is very rare and characterized by negative immunostaining for CD56 in the vast majority of cases 36–38 . Light chain restriction can be readily demonstrated by paraffin immunohistochemistry in plasma cell myeloma but not in B‐cell lymphoma including PBL 1,14,24,39 .…”

Section: Discussionmentioning

confidence: 99%

Plasmablastic lymphoma of the stomach in an HIV‐negative patient

Hashimoto

Inaguma

Kasai

et al. 2012

Pathology International

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Plasmablastic lymphoma (PBL) is a rare B-cell neoplasm with an aggressive clinical behavior that predominantly occurs in the oral cavity of human immunodeficiency virus (HIV)-positive patients. However, it has recently been recognized that PBLs can also affect individuals without HIV infection, and suggested that these neoplasms show different clinicopathological characteristics between HIV-positive and -negative patients. Herein we describe a case of gastric PBL in a female HIV-negative patient. The tumor was composed of a diffuse and cohesive proliferation of large neoplastic cells, which resembled immunoblasts or plasmablasts with a starry sky appearance. Immunophenotypically, the neoplastic cells were diffusely positive for CD138, MUM1, IgM, and BOB-1, and negative for CK, LCA, CD3, CD20, CD79a, Pax5, kappa, lambda, CD30, ALK, S-100, HMB-45, MPO, and HHV-8. The MIB-1 index was nearly 100%. Epstein-Barr virus-encoded RNA in situ hybridization was negative. A monoclonal immunoglobulin heavy chain gene rearrangement was detected in polymerase chain reaction (PCR) and heteroduplex analyses. A combination of PCR-based analysis of immunoglobulin gene rearrangement and immunohistochemistry can be useful to substantiate the diagnosis by utilizing routine paraffin-embedded tissue sections, because PBL in the setting of extra-oral localization and immunocompetence is a diagnostic challenge, given its rarity, morphology, and absence of CD20 expression.

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IgM multiple myeloma: More on a rare and heterogeneous disease

Cited by 5 publications

References 7 publications

IgM Multiple Myeloma

IgM Multiple Myeloma

Atypical IgM multiple myeloma with deletion of c‐MAF

Plasmablastic lymphoma of the stomach in an HIV‐negative patient

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