Plasma Cell Lesions Research Articles

Immunohistochemical staining of neoplastic and inflammatory plasma cell lesions in feline tissues

Two cases of feline plasmacytoma and nine cases of reactive plasma cell proliferations were examined for the presence of cytoplasmic immunoglobulin light chain types and heavy chain classes, by the peroxidase-anti-peroxidase technique on sections of formalin-fixed, paraffin-embedded tissues. This immunohistochemical technique is an important aid to conventional histological techniques. It helps to differentiate between neoplastic and dense inflammatory plasma cell proliferations by determining the presence of one, or more than one, light chain types in the cells, which corresponds with their neoplastic or reactive nature.

Orbital Manifestations of Piasmacytic Lymphoproliferations

Orbital involvement by plasmacytic lymphoproliferative disorders is rare. Presented are four cases, with different clinical onsets and courses, demonstrating the diversity of expression of lymphoproliferative plasma cell lesions of the orbit. The first patient presented with a slowly developing palpable mass in the upper and anterior orbit. This localized lesion proved to be a reactive plasma cell proliferation. The second case had a 3-month history of proptosis, diplopia, and droopy eyelid and a pulsatile temporal mass with bone destruction. Results of biopsy and systemic investigations showed a solitary plasmacytoma of bone. In the third case, a patient with a known multiple myeloma for 2 years presented with a progressive osteolytic mass which proved on biopsy to be a plasmacytoma. At the time, she also had other active bone lesions. The fourth case presented as a possible orbital cellulitis in a man with known multiple myeloma for 2 years. He proved to have disseminated myeloma, the orbital infiltrate being secondary to sinus involvement. The differential diagnosis for each case can be quite involved. Each case required a biopsy for an accurate diagnosis in addition to a complete clinical, radiographic, and laboratory workup. The pathologic features of each tumor can be misleading. These will be discussed as well as the use of ancillary diagnostic methods such as electron microscopy and immunohistochemistry to further characterize each lesion. The clinical course and treatment modalities will be discussed.

Extranodal oral lymphoma. Part I. A morphologic and immunoperoxidase study of 34 cases

Thirty-four cases of oral lymphoma were classified by the Lukes-Collins system on the basis of morphology and immunoperoxidase staining. Ninety-seven percent of these were morphologically identified as B-cell neoplasms: 6% SCFCC, 9% LCFCC, 26% SNCFCC, 24% LNCFCC, 12% IBS, and 18% malignant plasma cell proliferations. Monoclonal immunoperoxidase staining for cytoplasmic immunoglobulin was positive in 41% of the cases overall, but 100% of the cases of immunoblastic sarcoma and malignant plasma cell lesions stained positively.

Plasma cell lesions of the head and neck: Immunofluorescent determination of clonality from formalin-fixed, paraffin-embedded tissue

An immunofluorescent technique was used on formalin-fixed, paraffin-embedded tissue to characterize and diagnose plasma cell lesions of the head and neck. Infiltrates were classified as either monoclonal or polyclonal with rhodamine and fluorescein staining of light chains and heavy chains. In the cases in which histopathologic diagnoses were relatively certain, immunofluorescence provided good correlation. In those cases in which histopathologic diagnoses were equivocal, immunofluorescence distinguished between reactive and neoplastic infiltrates through the determination of clonality of the infiltrates.

Pathology consultation. Plasma cell tumors of the head and neck.

Neoplastic plasma cell disorders, multiple myeloma, extramedullary plasmacytoma and solitary plasmacytoma affect the head and neck with different manifestations. Multiple lytic lesions of the jaws and infrequent soft-tissue lesions characterize multiple myeloma's presence. The solitary plasmacytoma of bone is infrequent in the jaws. Wherever it occurs, it is a precursor lesion to multiple myeloma. Extramedullary plasmacytoma has several clinical and biologic forms. The most benign is the local upper airway lesion that is amenable to surgery or radiotherapy and manifests no recurrences. Approximately 40%, however, terminate in osseous and soft-tissue dissemination. The distant involvement has more characteristics of metastases than the diffuse axial skeletal involvement of multiple myeloma; to acknowledge this distribution and the apparently better prognosis, the disseminated form is called myelomatosis.

Plasma cell lesions within the oral tissues: Immunoperoxidase staining of routinely fixed and processed tissue

Multiple and solitary myeloma of bone and extramedullary plasmacytoma are often associated with primary or secondary involvement of the oral cavity. With conventional histologic techniques, differentiation of these neoplastic proliferations from the dense plasma cell infiltrates commonly accompanying inflammatory processes in the oral tissues can present a diagnostic problem. This article presents eight cases of plasma cell or plasma cell-like lesions within the oral tissues to illustrate the way in which immunoperoxidase techniques on routinely fixed and embedded tissues can aid histologic methods.

Diagnostic use of immunoperoxidase techniques for plasma cell lesions of the jaws

This article presents four bony destructive lesions of the jaws which, on microscopic examination, were composed almost exclusively of plasma cells. The use of the peroxidase-antiperoxidase immunohistochemical technique to differentiate those plasma cell lesions which present polyclonal staining with antihuman immunoglobulins and those which present monoclonal staining is described. At the present state of knowledge, the demonstration of monotypia in a plasma cell lesion is taken as presumptive evidence of neoplasia.

Ultrastructural study of pulmonary plasma cell granuloma—report of a case

Electron microscopy of a tumour diagnosed as a pulmonary plasma cell granuloma showed that the tumour was composed of plasma cells, fibroblasts, histiocytes and other inflammatory cells. The plasma cells were mature, with abundant endoplasmic reticulum. Fibroblasts contained multiple lipid droplets and intracytoplasmic inclusions. The relationship between plasma cell granuloma and lesions believed to be related is discussed.

Ultrastructural study of pulmonary plasma cell granuloma—report of a case

Electron microscopy of a tumour diagnosed as a pulmonary plasma cell granuloma showed that the tumour was composed of plasma cells, fibroblasts, histiocytes and other inflammatory cells. The plasma cells were mature, with abundant endoplasmic reticulum. Fibroblasts contained multiple lipid droplets and intracytoplasmic inclusions. The relationship between plasma cell granuloma and lesions believed to be related is discussed.

Transplantable Murine Salivary Gland Carcinoma (Myoepithelioma). I. Biologic Behavior and Ultrastructural Features2

Three salivary gland adenocarcinomas that arose spontaneously in female BALB/c mice, originally being maintained for plasmacytoma (MOPC) investigations, were studied; only one of the original hosts was MOPC-bearing. The initial carcinomas clearly originated from the salivary gland, not the breast, and did not resemble plasma cell lesions. The submandibular gland was the site of origin in each instance. Lesions were identical to those described previously in strains A and C mice as myoepitheliomas, with intracellular fibrils positive by phosphotungstic acid-hematoxylin (PTAH) stain. Each cell line (A, B, and C) of the salivary gland carcinomas was serially transplanted for 28, 29 and 14 generations, respecitvely. The lesion was easily transplanted, achieved almost 100% takes, and uniformly killed the host in 6-12 weeks, with metastasis to the peritoneum and liver. A myeloproliferative reaction characterized by leukemoid changes regularly occurred during the growth of the tumors. Each transplant generation was identical to its original salivary gland precursor by light and electron microscopy. In their growth pattern, the tumors resembled sarcomas with large areas of spindle cells. Ultrastructurally, the neoplastic cells contained the organelles of acinar and possibly ductal cells and exhibited varying degrees of synthetic and secretory activity, characterized by abundant free ribosomes and granular ergastoplasm, with prominent canaliculi containing abundant secretory material. Numerous desmosomes were seen, as well as coarse filaments and fine fibrils in most tumors cells, particularly in cells exhibiting lesser degrees of secretion. The filaments most likely represented the PTAH-positive intracellular fibrils observed by light microscopy. All tumors had numerous cells with resting features.

Hyaline-vascular and plasma-cell types of giant lymph node hyperplasia of the mediastinum and other locations.

A clinicopathologic analysis of 81 cases of giant lymph node hyperplasia was undertaken, with review of previously reported cases. Most of the lesions were intrathoracic. The lesions were discovered most often on routine roentgeno-grams of the chest or because of pressure symptoms or the presence of a palpable mass if outside the thorax. Evidence is presented that the lesions are enlarged, hyperplastic, altered lymph nodes. They have been divided into 2 histologic types: the hyaline-vascular lesions, which were most numerous, were characterized by small hyaline-vascular follicles and interfollicular capillary proliferation; the plasma-cell lesions were characterized by large follicles with intervening sheets of plasma cells. Systemic manifestations, such as fever, anemia, and hyperglobulinemia, were frequently associated with the plasma-cell lesions. These clinical signs and other data presented appear to favor an infectious or inflammatory etiology. All the lesions have behaved in a benign fashion, and complete surgical excision has been curative.

Myeloma--like plasma cell lesion of the maxilla.

A review of the literature on myeloma is presented and an unusual case of a myeloma-like plasma cell lesion of the maxilla is reported. The definitive diagnosis was based on the highly characteristic histological appearances, the local immunological findings and the advanced clinical aspects of the condition. The absence of normally occurring immunoglobulins in the plasma cells was felt to be significant. It was an unusual case because the patient was so young and the involvement of oral soft tissues was so diffuse.

Intraocular manifestations of multiple myeloma.

The eyes of 15 autopsied patients with multiple myeloma were studied histologically. Twelve showed intraocular lesions. Five of the 15 cases had multiple pars plana cysts, seven of 11 had retinal capillary microaneurysms, and two had plasma cell lesions. The plasma cell lesions were a choroidal infitrate in a patient with plasma cell leukemia and a small, solitary plasmacytoma of the ciliary body in a patient with a similar lesion in the kidney. The multiple pars plana cysts were filled with proteinaceous material. They probably formed by splitting of the ciliary epithelium and accumulation of an abnormal blood protein. As yet, they have not been seen in the living patient. However, they are thought to be pathologically characteristic of multiple myeloma. Retinal capillary microaneurysms similar histologically to those seen in diabetes mellitus were found in the midperipheral retina. They did not bind fluorescent antihuman γ-globulin. A mutual exclusion of the pars plana cysts and the retinal microaneurysms were noted.

The Cystic Hyperplasia-Pyometra Complex in the Bitch

The thesis consists of two parts. The first is a clinical and pathological description of the cystic hyperplasia-pyometra complex in the bitch; the second is a study of the experimental reproduction of the various forms of the disease. The survey of the cystic hyperplasia-pyometra complex revaled that it is a disease of the older, nulliparous bitch which may become clinically manifest as an endometritis during the metoestral phase of the oestrus cycle. It the was possible to divide the cases into four broad groups on a histological basis. A gradation of histological changes could be traced from uncomplicated cystic glandular hyperplasia of the endometrium through acute endometritis. It was possible to correlate ovarian changes with those in the endometrium. Uncomplicated cystic glandular hyperplasia was observed at all stages of the cycle. In acute endometritis, the morphological appearance of the corpora lutea indicated that they were always active even at a stage in the cycle when they should normally have regressed. The plasma cell lesion was observed only in association with regressing corpora lutea. In the majority of the chronic cases, the corpora lutea had regressed though a few appeared active long after the normal period of regression. It is concluded from this survey that the aetiology and pathogenesis of the cystic hyperplasia-pyometra complex are intimately to the functional state of the ovaries; a contention supported by a series of experiments to study the effects of ovarian hormones on the endometrium of the ovariectomised bitch. Oestrogens in daily doses of 5 mg-25 mg. for periods up to 40 days failed to produce cystic glandular hyperplasia of the endometrium was produced. Since the natural disease requires several oestrus cycles in which to develop, it appeared essential to stimulate these by altermate treatment with oestrogen and progesterone. The first type of cycle used consisted of 10 daily injections of 5 mg. of stilboestrol dipropionate followed by 20 daily injections of 10 mg. of progesterone. The degree of cyctic glandular hyperplasia produced after four cycles of this type was comparable to that occurring in natural cases. The histological picture became complicated by increased collagen deposition and uterine fibrosis if the number of cycles was increased. Acute endometritis was produced by increasing the progesterone dosage from 10 mg. to 50 mg. per day during the sixth cycle in the animal. Using cycles in which the progesterone dose was 25 mg. per day, cystic glandular hyperplasia was produced after two cycles and acute endometritis supervened after four cycles. If progesterone was withheld there was relief of symptoms and spontaneous discharge of the uterine contents. The acute inflammatory reaction in the endometrium regressed and was replaced by plasma cell infiltrate. It was possible to reproduce the severe form of chronic endometritis by a combination of hormonal treatment and surgical interference uterine drainage. The pathogenetic and aetiological implications of these experiments are discussed in relation to the naturally occurring disease in the bitch.