Abstract
Introduction: Plasma cell neoplasms are monoclonal proliferations characterized by the secretion of an immunoglobulin product known as component "M" or monoclonal. The World Health Organization (WHO 2008) defines as plasma cell neoplasms the following: plasma cell myeloma, plasmacytoma and those syndromes defined by immunoglobulin deposits and primary amyloidosis, The objective of the present work was to correlate their clinical, morphological and phenotype characteristics in 21 patients. Material and Methods: A 2-year retrospective review was performed of the files of the surgical pathology laboratory and of the hematology service of the General Hospital of Mexico, searching for patients with a diagnosis of plasma cell neoplasm. We analyzed the following variables: age, gender, clinical symptoms, evolution, localization, laboratory tests, morphology, and expression of immunohistochemical markers. Of the 21 patients, 12 (57.1%) corresponded to plasma cell myelomas and 9 (42.8%) were plasmacytomas (seven extraosseous and two solitary bone plasmacytoma); women predominated with 61.4% and age ranged between 22 and 84 years. Mass and epistaxis were observed in the patients with plasmacytomas, and symptoms of medullary compression and anemia were observed in those patients with plasma cell myeloma. The time of symptomatology varied from 3 to 12 months. Laboratory tests revealed that lactate dehydrogenase (LDH), beta 2 microglobulin, C-reactive protein were altered and that hypercalcemia and anemia were present more in the systemic form of the disease. Treatment depended on the clinical staging and laboratory data. Mature forms predominated morphologically. Immunohistochemical stain revealed a constant expression for CD 138, six patients expressed CD 56, and expression of the Kappa and Lambda light chains was while.
Highlights
Plasma cell neoplasms are monoclonal proliferations characterized by the secretion of an immunoglobulin product known as component “M” or monoclonal
From the archives of the Surgical Pathology and Immunohistochemistry Service of the Pathology Unit of the General Hospital of Mexico, we reviewed the slides stained with hematoxylin-eosin, periodic acid-Shiff stain and the immunohistochemical markers of 21 patients diagnosed with plasma cell neoplasms and classified them according to WHO-2008 guidelines for hematolymphoid neoplasms [1] diagnosed in a two-year period (2006 and 2007)
At the Instituto Nacional de Cancerología [National Cancer Institute] in Mexico, 193 new cases of plasma cells myeloma were diagnosed between 2000-2004; of these 92 were men and 101 were women, and represented 1% of all the neoplasms diagnosed at this Institute [7]
Summary
Plasma cell neoplasms are monoclonal proliferations characterized by the secretion of an immunoglobulin product known as component “M” or monoclonal. Clonal proliferations of plasmatic cells and their precursors constitute a spectrum of diseases previously known as: “plasma cell dyscrasias” This group includes monoclonal gammopathy of indeterminate significance, which is characterized by the presence of low levels of paraprotein in the peripheral blood, with a variable time of evolution, and later on development of a plasma cells myeloma; this phenomenon is considered as a precursor lesion. A myeloma is a disease of adults with an average age of 62 years, it manifests by bone pain, lithic injuries in several bones, anemia, and recurring infections. It was first described in 1844 by Dr Samuel Solly, who assigned the name Mollities ossium to the condition [2]. It was in 1873 that Rustizky described and used for the first time the term “multiple myeloma” to point out the variety of bone lesions [4]
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