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    Anaplastic plasmacytoma with malignant pleural effusion lacking evidence of monoclonal gammopathy.

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    Authors
    Aoki, Takuya
    Okita, Hajime
    Kayano, Hidekazu
    Orikasa, Hideki
    Watanabe, Kentaro
    Eyden, Brian P
    Yamazaki, Kazuto
    Affiliation
    Department of Internal Medicine, Saiseikai Central Hospital, Tokyo, Japan.
    Issue Date
    2002-08
    
    Metadata
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    Abstract
    A case of plasmacytoma of the pleural cavity is reported with massive malignant pleural effusion, which, most unusually, lacked monoclonal gammopathy, thereby making it difficult to distinguish from lymphoma. The pleural tumor and pleural effusion contained large mononuclear lymphoma-like cells with distinct nucleoli. Immunohistochemistry revealed neither lymphoma markers nor clonal cytoplasmic nor cell surface immunoglobulins. Tumor cells were stained with vimentin and the plasma cell markers, VS38c, CD138 (syndecan-1), and MUM1 antibodies. Bone marrow contained small amounts of tumor consisting of similar cells. Electron microscopy showed well developed rough endoplasmic reticulum and peripherally positioned nuclei with euchromatin. Flow cytometry of bone marrow revealed a minimal involvement of CD38-positive cells. Chromosomal analysis of marrow cells revealed a complex abnormal karyotype. A polymerase chain reaction demonstrated clonal re-arrangement of the immunoglobulin heavy-chain gene. The overall results indicate a clonal expansion of tumor cells with primitive plasma cell differentiation with the highly unusual feature of absent monotypic immunoglobulin. The study illustrates the need for a comprehensive array of techniques to distinguish such rare non-synthesizing and non-secretory plasmacytomas from lymphoma.
    Citation
    Anaplastic plasmacytoma with malignant pleural effusion lacking evidence of monoclonal gammopathy. 2002, 441 (2):154-8 Virchows Arch.
    Journal
    Virchows Archiv
    URI
    http://hdl.handle.net/10541/80216
    DOI
    10.1007/s00428-001-0579-4
    PubMed ID
    12189505
    Type
    Article
    Language
    en
    ISSN
    0945-6317
    ae974a485f413a2113503eed53cd6c53
    10.1007/s00428-001-0579-4
    Scopus Count
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