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Well-differentiated (Marschalko-type) plasmacytoma resembling thyroid follicular structures.

Lara-Torres CO, Ortiz-Hidalgo C - J Hematop (2008)

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, The American British Cowdray Medical Center, Mexico City, Mexico.

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Dear Editor: Plasma cell neoplasms may display diverse cytoarchitectural variations, including a diffuse, nested, paragangliomatous, and angiomatoid arrangements... Histologically, the tumor was composed of thin strands of well-differentiated (Marschalko-type) neoplastic plasma cells that limited roughly rounded-to-irregular spaces with sharp scalloped borders filled with a homogeneous eosinophilic—PAS-positive—proteinaceous (‘colloid-like’) material, resembling thyroid follicle structures (Fig.  1a–b)... Congo red staining was negative... Kremer et al. have demonstrated that primary extramedullary plasmacytoma shows significant immunophenotypic differences with multiple myeloma with absence to low reactivity for cyclin D1, CD56, bcl-2, p21, and p53... In the so-called ‘nested’ pattern, groups of plasma cells may be surrounded by thin fibrovascular septa mimicking a neuroendocrine tumor, whereas in the ‘angiomatoid’ pattern, areas composed of pseudovascular spaces—limited by neoplastic plasma cells—may give the impression of a vascular neoplasm... Presence of variable-sized spaces limited by neoplastic plasma cells was also observed in our case, thus resembling the ‘angiomatoid’ pattern... However, in the angiomatoid areas of plasma cell tumors, proliferation of numerous stromal blood vessels or pseudovascular spaces filled with erythrocytes are found ; both features were absent in our case... Moreover, it is important to consider the presence of homogeneous, proteinaceous eosinophilic material in the context of a plasmacytic proliferation, as it may correspond to light chain amyloid deposition... Nonetheless, this was ruled out by the Congo red negative staining... Interestingly, various malignant tumors arising in organs other than the thyroid may also exhibit a similar thyroid follicle-like pattern, such as juvenile granulosa cell tumor of the ovary, thyroid-like breast tumor, thyroid follicular carcinoma-like tumor of the kidney, acinic cell carcinoma with follicular pattern, and malignant melanoma... To the best of our knowledge, this is the first report in the English literature of a plasma cell tumor displaying follicular and colloid-like structures, reminiscent of thyroid follicular histology.

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Immunoprofile of extramedullary plasmacytoma with follicle-like arrangement. The neoplastic cells and extracellular material are positive for kappa and negative for lambda light chains. Less than 2% of the neoplastic cells are positive for CD56, p21, and Ki-67; bcl-2 demonstrated a weak cytoplasmic staining in 15% of the tumor cells. Cyclin D1 and p53 are uniformly negative
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Fig2: Immunoprofile of extramedullary plasmacytoma with follicle-like arrangement. The neoplastic cells and extracellular material are positive for kappa and negative for lambda light chains. Less than 2% of the neoplastic cells are positive for CD56, p21, and Ki-67; bcl-2 demonstrated a weak cytoplasmic staining in 15% of the tumor cells. Cyclin D1 and p53 are uniformly negative

Mentions: The neoplastic plasma cells were negative for CD20 (Clone L26 BioSb; 1:50) and showed strong membranal immunoreactivity for CD138 (Clone B-B4, Cell Marque; 1:50) (Fig. 1c) as well as kappa light chain restriction (Clone L1C1, Cell Marque; 1:4,000). Likewise, the ‘colloid-like’ material showed kappa light chain restriction, demonstrating that it was, in fact, immunoglobulin secreted by the neoplastic plasma cells (Fig. 2). Congo red staining was negative.Fig. 2


Well-differentiated (Marschalko-type) plasmacytoma resembling thyroid follicular structures.

Lara-Torres CO, Ortiz-Hidalgo C - J Hematop (2008)

Immunoprofile of extramedullary plasmacytoma with follicle-like arrangement. The neoplastic cells and extracellular material are positive for kappa and negative for lambda light chains. Less than 2% of the neoplastic cells are positive for CD56, p21, and Ki-67; bcl-2 demonstrated a weak cytoplasmic staining in 15% of the tumor cells. Cyclin D1 and p53 are uniformly negative
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC2713489&req=5

Fig2: Immunoprofile of extramedullary plasmacytoma with follicle-like arrangement. The neoplastic cells and extracellular material are positive for kappa and negative for lambda light chains. Less than 2% of the neoplastic cells are positive for CD56, p21, and Ki-67; bcl-2 demonstrated a weak cytoplasmic staining in 15% of the tumor cells. Cyclin D1 and p53 are uniformly negative
Mentions: The neoplastic plasma cells were negative for CD20 (Clone L26 BioSb; 1:50) and showed strong membranal immunoreactivity for CD138 (Clone B-B4, Cell Marque; 1:50) (Fig. 1c) as well as kappa light chain restriction (Clone L1C1, Cell Marque; 1:4,000). Likewise, the ‘colloid-like’ material showed kappa light chain restriction, demonstrating that it was, in fact, immunoglobulin secreted by the neoplastic plasma cells (Fig. 2). Congo red staining was negative.Fig. 2

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, The American British Cowdray Medical Center, Mexico City, Mexico.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Dear Editor: Plasma cell neoplasms may display diverse cytoarchitectural variations, including a diffuse, nested, paragangliomatous, and angiomatoid arrangements... Histologically, the tumor was composed of thin strands of well-differentiated (Marschalko-type) neoplastic plasma cells that limited roughly rounded-to-irregular spaces with sharp scalloped borders filled with a homogeneous eosinophilic—PAS-positive—proteinaceous (‘colloid-like’) material, resembling thyroid follicle structures (Fig.  1a–b)... Congo red staining was negative... Kremer et al. have demonstrated that primary extramedullary plasmacytoma shows significant immunophenotypic differences with multiple myeloma with absence to low reactivity for cyclin D1, CD56, bcl-2, p21, and p53... In the so-called ‘nested’ pattern, groups of plasma cells may be surrounded by thin fibrovascular septa mimicking a neuroendocrine tumor, whereas in the ‘angiomatoid’ pattern, areas composed of pseudovascular spaces—limited by neoplastic plasma cells—may give the impression of a vascular neoplasm... Presence of variable-sized spaces limited by neoplastic plasma cells was also observed in our case, thus resembling the ‘angiomatoid’ pattern... However, in the angiomatoid areas of plasma cell tumors, proliferation of numerous stromal blood vessels or pseudovascular spaces filled with erythrocytes are found ; both features were absent in our case... Moreover, it is important to consider the presence of homogeneous, proteinaceous eosinophilic material in the context of a plasmacytic proliferation, as it may correspond to light chain amyloid deposition... Nonetheless, this was ruled out by the Congo red negative staining... Interestingly, various malignant tumors arising in organs other than the thyroid may also exhibit a similar thyroid follicle-like pattern, such as juvenile granulosa cell tumor of the ovary, thyroid-like breast tumor, thyroid follicular carcinoma-like tumor of the kidney, acinic cell carcinoma with follicular pattern, and malignant melanoma... To the best of our knowledge, this is the first report in the English literature of a plasma cell tumor displaying follicular and colloid-like structures, reminiscent of thyroid follicular histology.

No MeSH data available.


Related in: MedlinePlus