Diagnostic Panel of Markers CD45, CD20, CD3, CD138, and CD56 for Oral Solitary Plasmacytoma of Bone

Abstract

ABSTRACT Aim The present case aims to emphasize on the role of immunophenotyping in plasmacytic malignancies. Introduction Solitary plasmacytoma of bone (SPB) is a rare entity often encountered in vertebrae and less frequently in long bones. Its presence in jaws is extremely rare, accounting for 4.4% of cases only. About 5% of patients with plasma cell dyscrasias present with SPB. Case report An elderly male patient reported with a chief complaint of growth in the anterior region of the lower jaw since 3 months. The histopathological features following an incisional biopsy were suggestive of pyogenic granuloma. Serological investigations revealed seropositivity for human immunodeficiency virus (HIV)-1 antibody with hypergammaglobulinemia and hypoalbuminemia. Histopathology of excisional biopsied tissue revealed a round cell malignancy with plasmacytic morphology. Further, to arrive at a specific final diagnosis, immunohistochemistry (IHC) was employed with a panel of markers CD45, CD20, CD3, CD138, and CD56. This panel enabled us to establish a final diagnosis of SPB with clinicopathologic correlation. Conclusion The present case posed a diagnostic dilemma as it presented with overlapping features of non-Hodgkin's lymphoma (NHL), multiple myeloma (MM), extramedullary plasmacytoma (EMP), and plasmablastic lymphoma (PBL). A thorough clinical, radiological, serological, and IHC panel helped to diagnose the present case. The CD56 enabled differentiation between SPB and PBL. Thereby, this article emphasizes on the need for a panel of IHC markers that permit definitive diagnosis of lymphopoietic malignancies. Clinical significance Timely diagnosis of malignant lesions is an essential concern for effective management. Thus, we emphasize that the IHC is a valuable investigative tool in the diagnosis of round cell tumors with plasmacytoid morphology. How to cite this article Abraham M, Augustine D, Sagar P, Rao RS, Prasad K, Sowmya SV, Haragannavar VC, Nambiar S. Diagnostic Panel of Markers CD45, CD20, CD3, CD138, and CD56 for Oral Solitary Plasmacytoma of Bone. World J Dent 2018;9(1):53-58.