Extraosseous (extramedullary) plasmacytomas: a clinicopathologic and immunophenotypic study of 32 Chinese cases

Diagnostic Pathology - Tập 6 - Trang 1-11 - 2011
Zhuo Zuo1, Yuan Tang1, Cheng-Feng Bi1, Wen-Yan Zhang1, Sha Zhao1, Xiao-Qing Wang1, Qun-Pei Yang1, Li-Qun Zou2, Wei-Ping Liu1
1Department of Pathology, West China Hospital of Sichuan University, Chengdu, China
2Department of Oncology, West China Hospital of Sichuan University, Chengdu, China

Tóm tắt

Extraosseous plasmacytoma, so called extramedullary plasmacytoma (EMP) is relatively rare in China. The aim was investigate the clinicopathologic features of EMP and the role of Immunophenotype and genotype detection in diagnosis of EMP. Thirty-two cases of EMP were investigated retrospectively by histopathology, immunophenotype, genotype and survival analysis. Clinically, the mean age of the patients was 53.4. Most of the patients received no treatment after the diagnosis was established, and the prognosis was relatively poor. Histologically, in 40% of the cases, the neoplastic cells were grade II or III. The neoplastic cells expressed one or more PC associated antigens. The immunophenotype of EMP and inflammation of sinonasal regions with numerous PC infiltrations were compared and showed some difference in expression of CD45, CD27, CD44v6 and Bcl-2 as well. Ig light chain restriction was detected in 87.5% of the cases. we described 32 Chinese cases of EMP, compare with that reported in the literature, some differences are presented, including higher percentage of grade II and III cases, clinically inconsistent treatment and management as well as poor outcome of the disease.

Tài liệu tham khảo

SH Swerdlow EC, Harris NL, Jaffe ES, Pileri SA, Thiele J, et al.: WHO classification of tumours of haematopoietic and lymphoid tissues, International Agency for Research on Cancer (IARC). 2008, Lyon, France Alexiou C, Kau RJ, Dietzfelbinger H, Kremer M, Spieβ JC, Schratzenstaller B, Arnold W: Extramedullary plasmacytoma. Cancer. 1999, 85: 2305-2314. Bachar G, Goldstein D, Brown D, Tsang R, Lockwood G, Perez-Ordonez B, Irish J: Solitary extramedullary plasmacytoma of the head and neck--Long-term outcome analysis of 68 cases. Head & Neck. 2008, 30: 1012-1019. Kremer M, Ott G, Nathrath M, Specht K, Stecker K, Alexiou C, Quintanilla-Martinez L, Fend F: Primary extramedullary plasmacytoma and multiple myeloma: phenotypic differences revealed by immunohistochemical analysis. The Journal of Pathology. 2005, 205: 92-101. Dores GM, Landgren O, McGlynn KA, Curtis RE, Linet MS, Devesa SS: Plasmacytoma of bone, extramedullary plasmacytoma, and multiple myeloma: incidence and survival in the United States, 1992-2004. British Journal of Haematology. 2009, 144: 86-94. Soutar R, Lucraft H, Jackson G, Reece A, Bird J, Low E, Samson D: Guidelines on the diagnosis and management of solitary plasmacytoma of bone and solitary extramedullary plasmacytoma. British Journal of Haematology. 2004, 124: 717-726. Bartl RFB, Fateh-Moghadam A, Kettner G, Jaeger K, Sommerfeld W: Histologic classification and staging of multiple myeloma: a retrospective and prospective study of 674 cases. Am J Clin Pathol. 1987, 87: 342-355. van Dongen JJM, Langerak AW, Bruggemann M, Evans PAS, Hummel M, Lavender FL, Delabesse E, Davi F, Schuuring E, Garcia-Sanz R, et al.: Design and standardization of PCR primers and protocols for detection of clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: Report of the BIOMED-2 Concerted Action BMH4-CT98-3936. Leukemia. 2003, 17: 2257-2317. Weber DM: Solitary Bone and Extramedullary Plasmacytoma. Hematology. 2005, 2005: 373-376. Susnerwala S, Shanks JH, Banerjee SS, Scarffe JH, Farrington WT, Slevin NJ: Extramedullary plasmacytoma of the head and neck region: clinicopathological correlation in 25 cases. British Journal of Cancer. 1997, 75: 921-927. Mendenhall WM, Mendenhall CM, Mendenhall NP: Solitary plasmacytoma of bone and soft tissues. American Journal of Otolaryngology. 2003, 24: 395-399. Kumar S, Rajkumar SV, Kimlinger T, Greipp PR, Witzig TE: CD45 expression by bone marrow plasma cells in multiple myeloma: clinical and biological correlations. Leukemia. 2005, 19: 1466-1470. Moreau P, Robillard N, Avet-Loiseau H, Pineau D, Morineau N, Milpied N, Harousseau J, Bataille R: Patients with CD45 negative multiple myeloma receiving high-dose therapy have a shorter survival than those with CD45 positive multiple myeloma. Haematologica. 2004, 89: 547-551. Van Camp B, Durie B, Spier C, De Waele M, Van Riet I, Vela E, Frutiger Y, Richter L, Grogan T: Plasma cells in multiple myeloma express a natural killer cell- associated antigen: CD56 (NKH-1; Leu-19). Blood. 1990, 76: 377-382. Pellat-Deceunynck C, Bataille R, Robillard N, Harousseau J, Rapp M, Juge-Morineau N, Wijdenes J, Amiot M: Expression of CD28 and CD40 in human myeloma cells: a comparative study with normal plasma cells. Blood. 1994, 84: 2597-2603. Pellat-Deceunynck C, Barillé S, Puthier D, Rapp M-J, Harousseau J-L, Bataille R, Amiot M: Adhesion Molecules on Human Myeloma Cells: Significant Changes in Expression Related to Malignancy, Tumor Spreading, and Immortalization. Cancer Research. 1995, 55: 3647-3653. Kouno T, Watanabe T, Umeda T, Beppu Y, Kojima R, Sungwon K, Kobayashi Y, Tobinai K, Hasegawa T, Matsuno Y: CD56-positive Small Round Cell Tumor: Osseous Plasmacytoma Manifested in Osteolytic Tumors of the Iliac Bone and Femora. Japanese Journal of Clinical Oncology. 2005, 35: 90-93. Camerini D, Walz G, Loenen W, Borst J, Seed B: The T cell activation antigen CD27 is a member of the nerve growth factor/tumor necrosis factor receptor gene family. The Journal of Immunology. 1991, 147: 3165-3169. Goodwin RG, Alderson MR, Smith CA, Armitage RJ, VandenBos T, Jerzy R, Tough TW, Schoenborn MA, Davis-Smith T, Hennen K, et al.: Molecular and biological characterization of a ligand for CD27 defines a new family of cytokines with homology to tumor necrosis factor. Cell. 1993, 73: 447-456. Maurer D, Holter W, Majdic O, Fischer GF, Knapp W: CD27 expression by a distinct subpopulation of human B lymphocytes. European Journal of Immunology. 1990, 20: 2679-2684. Klein U, Rajewsky K, Küppers R: Human Immunoglobulin (Ig)M+IgD+ Peripheral Blood B Cells Expressing the CD27 Cell Surface Antigen Carry Somatically Mutated Variable Region Genes: CD27 as a General Marker for Somatically Mutated (Memory) B Cells. The Journal of Experimental Medicine. 1998, 188: 1679-1689. Tangye SG, Liu Y-J, Aversa G, Phillips JH, de Vries JE: Identification of Functional Human Splenic Memory B Cells by Expression of CD148 and CD27. The Journal of Experimental Medicine. 1998, 188: 1691-1703. Lens SMA, Jong RD, Hintzen RQ, Koopman G, Van Lier RAW, Van Oers RHJ: CD27-CD70 Interaction: Unravelling its Implication in Normal and Neoplastic B-Cell Growth. Leukemia & Lymphoma. 1995, 18: 51-59. Agematsu K, Hokibara S, Nagumo H, Komiyama A: CD27: a memory B-cell marker. Immunology Today. 2000, 21: 204-206. Farstad IN, Carlsen H, Morton HC, Brandtzaeg P: Immunoglobulin A cell distribution in the human small intestine: phenotypic and functional characteristics. Immunology. 2000, 101: 354-363. Jung J, Choe J, Li L, Choi YS: Regulation of CD27 expression in the course of germinal center B cell differentiation: the pivotal role of IL-10. European Journal of Immunology. 2000, 30: 2437-2443. Zhan F, Hardin J, Kordsmeier B, Bumm K, Zheng M, Tian E, Sanderson R, Yang Y, Wilson C, Zangari M, et al.: Global gene expression profiling of multiple myeloma, monoclonal gammopathy of undetermined significance, and normal bone marrow plasma cells. Blood. 2002, 99: 1745-1757. Katayama Y, Sakai A, Oue N, Asaoku H, Otsuki T, Shiomomura T, Masuda R, Hino N, Takimoto Y, Imanaka F, et al.: A possible role for the loss of CD27-CD70 interaction in myelomagenesis. British Journal of Haematology. 2003, 120: 223-234. Moreau P, Robillard N, Jégo G, Pellat C, Gouill SL, Thoumi S, Avet-Loiseau H, Harousseau J-L, Bataille R: Lack of CD27 in myeloma delineates different presentation and outcome. British Journal of Haematology. 2006, 132: 168-170. Guikema JEJ, Hovenga S, Vellenga E, Conradie JJ, Abdulahad WH, Bekkema R, Smit JW, Zhan F, Shaughnessy J, Bos NA: CD27 is heterogeneously expressed in multiple myeloma: low CD27 expression in patients with high-risk disease. British Journal of Haematology. 2003, 121: 36-43. Degrassi A, Hilbert DM, Rudikoff S, Anderson AO, Potter M, Coon HG: In vitro culture of primary plasmacytomas requires stromal cell feeder layers. Proceedings of the National Academy of Sciences. 1993, 90: 2060-2064. Okada T, Hawley RG: Adhesion molecules involved in the binding of murine myeloma cells to bone marrow stromal elements. International Journal of Cancer. 1995, 63: 823-830. Asosingh K, Günthert U, Bakkus MHC, De Raeve H, Goes E, Van Riet I, Van Camp B, Vanderkerken K: In Vivo Induction of Insulin-like Growth Factor-I Receptor and CD44v6 Confers Homing and Adhesion to Murine Multiple Myeloma Cells. Cancer Research. 2000, 60: 3096-3104. Lokhorst H, Lamme T, de Smet M, Klein S, de Weger R, van Oers R, Bloem A: Primary tumor cells of myeloma patients induce interleukin-6 secretion in long-term bone marrow cultures. Blood. 1994, 84: 2269-2277. UG: CD44: a multitude of isoforms with diverse functions. Anglais. 1993, 184: 47-63. Liebisch P, Eppinger S, Schopflin C, Stehle G, Munzert G, Dohner H, Schmid M: CD44v6, a target for novel antibody treatment approaches, is frequently expressed in multiple myeloma and associated with deletion of chromosome arm 13q. Haematologica. 2005, 90: 489-493. Eisterer W, Bechter O, Hilbe W, van Driel M, Lokhorst HM, Thaler J, Bloem AC, Günthert U, Stauder R: CD44 isoforms are differentially regulated in plasma cell dyscrasias and CD44v9 represents a new independent prognostic parameter in multiple myeloma. Leukemia Research. 2001, 25: 1051-1057.