Immunophenotypic features by multiparameter flow cytometry can help distinguish low grade B-cell lymphomas with plasmacytic differentiation from plasma cell proliferative disorders with an unrelated clonal B-cell process
Open Access
- 2 February 2015
- journal article
- research article
- Published by Wiley in British Journal of Haematology
- Vol. 169 (3), 368-376
- https://doi.org/10.1111/bjh.13303
Abstract
Highly sensitive flow cytometry studies may incidentally identify B cell clones when used to assess plasma cell clonality in bone marrows. Clinical history, which can help differentiate related clones (low grade B cell lymphoma with plasmacytic differentiation/LBCL‐PD) from unrelated ones (plasma cell proliferative disorder (PCPD) with an unrelated B cell clone), is often unavailable in referred specimens. We sought to identify morphologic or phenotypic features that would help predict the significance of these clones in the absence of history. We included only cases with identical light chain B and plasma cell clones, as determined by 6‐color flow cytometry with additional DNA ploidy analysis, in which the relationship between clones could be established by review of medical records. There were 26 cases; 18 were related (14 were Waldenstrom macroglobulinemia) and eight were unrelated (seven multiple myeloma). Features seen exclusively in LBCL‐PD include CD19+/CD45+ clonal plasma cell phenotype (66·7%, P = 0·0022) and morphologic features such as paratrabecular bone marrow involvement, increased mast cells, and plasma cells surrounding B‐cell nodules. Aneuploidy was identified exclusively in PCPD cases (75%, P = 0·000028). We conclude that CD19+/CD45+ clonal plasma cell phenotype and aneuploidy are useful in distinguishing related clones (LBCL‐PD) from unrelated clones (PCPD).This publication has 27 references indexed in Scilit:
- Flow Cytometric Analysis of Surface Light Chain Expression Patterns in B-Cell Lymphomas Using Monoclonal and Polyclonal AntibodiesAmerican Journal of Clinical Pathology, 2011
- Novel immunophenotypic features of marrow lymphoplasmacytic lymphoma and correlation with Waldenström's macroglobulinemiaLaboratory Investigation, 2009
- Translocation t(11;14) and survival of patients with light chain (AL) amyloidosisHaematologica, 2009
- Immunophenotypic Differentiation Between Neoplastic Plasma Cells in Mature B-Cell Lymphoma vs Plasma Cell MyelomaAmerican Journal of Clinical Pathology, 2007
- Trisomy 4, a new chromosomal abnormality in Waldenström's macroglobulinemia: a study of 39 casesLeukemia, 2006
- Characterization of Incidentally Identified Minute Clonal B-Lymphocyte Populations in Peripheral Blood and Bone MarrowAmerican Journal of Clinical Pathology, 2004
- Proliferative activity of plasma cells is the most relevant prognostic factor in elderly multiple myeloma patientsInternational Journal of Cancer, 2004
- Despite apparent morphologic and immunophenotypic heterogeneity, Waldenstrom's macroglobulinemia is consistently composed of cells along a morphologic continuum of small lymphocytes, plasmacytoid lymphocytes, and plasma cellsSeminars in Oncology, 2003
- Cytogenetic Findings in Lymphoplasmacytic Lymphoma /Waldenström MacroglobulinemiaAmerican Journal of Clinical Pathology, 2001
- DNA Cell Content Studies in Multiple MyelomaLeukemia & Lymphoma, 1996