Skip to main content
Top
Published in: Diagnostic Pathology 1/2011

Open Access 01-12-2011 | Research

Extraosseous (extramedullary) plasmacytomas: a clinicopathologic and immunophenotypic study of 32 Chinese cases

Authors: Zhuo Zuo, Yuan Tang, Cheng-Feng Bi, Wen-Yan Zhang, Sha Zhao, Xiao-Qing Wang, Qun-Pei Yang, Li-Qun Zou, Wei-Ping Liu

Published in: Diagnostic Pathology | Issue 1/2011

Login to get access

Abstract

Background

Extraosseous plasmacytoma, so called extramedullary plasmacytoma (EMP) is relatively rare in China. The aim was investigate the clinicopathologic features of EMP and the role of Immunophenotype and genotype detection in diagnosis of EMP.

Methods

Thirty-two cases of EMP were investigated retrospectively by histopathology, immunophenotype, genotype and survival analysis.

Results

Clinically, the mean age of the patients was 53.4. Most of the patients received no treatment after the diagnosis was established, and the prognosis was relatively poor. Histologically, in 40% of the cases, the neoplastic cells were grade II or III. The neoplastic cells expressed one or more PC associated antigens. The immunophenotype of EMP and inflammation of sinonasal regions with numerous PC infiltrations were compared and showed some difference in expression of CD45, CD27, CD44v6 and Bcl-2 as well. Ig light chain restriction was detected in 87.5% of the cases.

Conclusions

we described 32 Chinese cases of EMP, compare with that reported in the literature, some differences are presented, including higher percentage of grade II and III cases, clinically inconsistent treatment and management as well as poor outcome of the disease.
Appendix
Available only for authorised users
Literature
1.
go back to reference SH Swerdlow EC, Harris NL, Jaffe ES, Pileri SA, Thiele J, et al.: WHO classification of tumours of haematopoietic and lymphoid tissues, International Agency for Research on Cancer (IARC). 2008, Lyon, France SH Swerdlow EC, Harris NL, Jaffe ES, Pileri SA, Thiele J, et al.: WHO classification of tumours of haematopoietic and lymphoid tissues, International Agency for Research on Cancer (IARC). 2008, Lyon, France
2.
go back to reference Alexiou C, Kau RJ, Dietzfelbinger H, Kremer M, Spieβ JC, Schratzenstaller B, Arnold W: Extramedullary plasmacytoma. Cancer. 1999, 85: 2305-2314.CrossRefPubMed Alexiou C, Kau RJ, Dietzfelbinger H, Kremer M, Spieβ JC, Schratzenstaller B, Arnold W: Extramedullary plasmacytoma. Cancer. 1999, 85: 2305-2314.CrossRefPubMed
3.
go back to reference Bachar G, Goldstein D, Brown D, Tsang R, Lockwood G, Perez-Ordonez B, Irish J: Solitary extramedullary plasmacytoma of the head and neck--Long-term outcome analysis of 68 cases. Head & Neck. 2008, 30: 1012-1019.CrossRef Bachar G, Goldstein D, Brown D, Tsang R, Lockwood G, Perez-Ordonez B, Irish J: Solitary extramedullary plasmacytoma of the head and neck--Long-term outcome analysis of 68 cases. Head & Neck. 2008, 30: 1012-1019.CrossRef
4.
go back to reference Kremer M, Ott G, Nathrath M, Specht K, Stecker K, Alexiou C, Quintanilla-Martinez L, Fend F: Primary extramedullary plasmacytoma and multiple myeloma: phenotypic differences revealed by immunohistochemical analysis. The Journal of Pathology. 2005, 205: 92-101.CrossRefPubMed Kremer M, Ott G, Nathrath M, Specht K, Stecker K, Alexiou C, Quintanilla-Martinez L, Fend F: Primary extramedullary plasmacytoma and multiple myeloma: phenotypic differences revealed by immunohistochemical analysis. The Journal of Pathology. 2005, 205: 92-101.CrossRefPubMed
5.
go back to reference Dores GM, Landgren O, McGlynn KA, Curtis RE, Linet MS, Devesa SS: Plasmacytoma of bone, extramedullary plasmacytoma, and multiple myeloma: incidence and survival in the United States, 1992-2004. British Journal of Haematology. 2009, 144: 86-94.PubMedCentralCrossRefPubMed Dores GM, Landgren O, McGlynn KA, Curtis RE, Linet MS, Devesa SS: Plasmacytoma of bone, extramedullary plasmacytoma, and multiple myeloma: incidence and survival in the United States, 1992-2004. British Journal of Haematology. 2009, 144: 86-94.PubMedCentralCrossRefPubMed
6.
go back to reference Soutar R, Lucraft H, Jackson G, Reece A, Bird J, Low E, Samson D: Guidelines on the diagnosis and management of solitary plasmacytoma of bone and solitary extramedullary plasmacytoma. British Journal of Haematology. 2004, 124: 717-726.CrossRefPubMed Soutar R, Lucraft H, Jackson G, Reece A, Bird J, Low E, Samson D: Guidelines on the diagnosis and management of solitary plasmacytoma of bone and solitary extramedullary plasmacytoma. British Journal of Haematology. 2004, 124: 717-726.CrossRefPubMed
7.
go back to reference Bartl RFB, Fateh-Moghadam A, Kettner G, Jaeger K, Sommerfeld W: Histologic classification and staging of multiple myeloma: a retrospective and prospective study of 674 cases. Am J Clin Pathol. 1987, 87: 342-355.PubMed Bartl RFB, Fateh-Moghadam A, Kettner G, Jaeger K, Sommerfeld W: Histologic classification and staging of multiple myeloma: a retrospective and prospective study of 674 cases. Am J Clin Pathol. 1987, 87: 342-355.PubMed
8.
go back to reference van Dongen JJM, Langerak AW, Bruggemann M, Evans PAS, Hummel M, Lavender FL, Delabesse E, Davi F, Schuuring E, Garcia-Sanz R, et al.: Design and standardization of PCR primers and protocols for detection of clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: Report of the BIOMED-2 Concerted Action BMH4-CT98-3936. Leukemia. 2003, 17: 2257-2317.CrossRefPubMed van Dongen JJM, Langerak AW, Bruggemann M, Evans PAS, Hummel M, Lavender FL, Delabesse E, Davi F, Schuuring E, Garcia-Sanz R, et al.: Design and standardization of PCR primers and protocols for detection of clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: Report of the BIOMED-2 Concerted Action BMH4-CT98-3936. Leukemia. 2003, 17: 2257-2317.CrossRefPubMed
9.
go back to reference Weber DM: Solitary Bone and Extramedullary Plasmacytoma. Hematology. 2005, 2005: 373-376.CrossRef Weber DM: Solitary Bone and Extramedullary Plasmacytoma. Hematology. 2005, 2005: 373-376.CrossRef
10.
go back to reference Susnerwala S, Shanks JH, Banerjee SS, Scarffe JH, Farrington WT, Slevin NJ: Extramedullary plasmacytoma of the head and neck region: clinicopathological correlation in 25 cases. British Journal of Cancer. 1997, 75: 921-927.PubMedCentralCrossRefPubMed Susnerwala S, Shanks JH, Banerjee SS, Scarffe JH, Farrington WT, Slevin NJ: Extramedullary plasmacytoma of the head and neck region: clinicopathological correlation in 25 cases. British Journal of Cancer. 1997, 75: 921-927.PubMedCentralCrossRefPubMed
11.
go back to reference Mendenhall WM, Mendenhall CM, Mendenhall NP: Solitary plasmacytoma of bone and soft tissues. American Journal of Otolaryngology. 2003, 24: 395-399.CrossRefPubMed Mendenhall WM, Mendenhall CM, Mendenhall NP: Solitary plasmacytoma of bone and soft tissues. American Journal of Otolaryngology. 2003, 24: 395-399.CrossRefPubMed
12.
go back to reference Kumar S, Rajkumar SV, Kimlinger T, Greipp PR, Witzig TE: CD45 expression by bone marrow plasma cells in multiple myeloma: clinical and biological correlations. Leukemia. 2005, 19: 1466-1470.CrossRefPubMed Kumar S, Rajkumar SV, Kimlinger T, Greipp PR, Witzig TE: CD45 expression by bone marrow plasma cells in multiple myeloma: clinical and biological correlations. Leukemia. 2005, 19: 1466-1470.CrossRefPubMed
13.
go back to reference Moreau P, Robillard N, Avet-Loiseau H, Pineau D, Morineau N, Milpied N, Harousseau J, Bataille R: Patients with CD45 negative multiple myeloma receiving high-dose therapy have a shorter survival than those with CD45 positive multiple myeloma. Haematologica. 2004, 89: 547-551.PubMed Moreau P, Robillard N, Avet-Loiseau H, Pineau D, Morineau N, Milpied N, Harousseau J, Bataille R: Patients with CD45 negative multiple myeloma receiving high-dose therapy have a shorter survival than those with CD45 positive multiple myeloma. Haematologica. 2004, 89: 547-551.PubMed
14.
go back to reference Van Camp B, Durie B, Spier C, De Waele M, Van Riet I, Vela E, Frutiger Y, Richter L, Grogan T: Plasma cells in multiple myeloma express a natural killer cell- associated antigen: CD56 (NKH-1; Leu-19). Blood. 1990, 76: 377-382.PubMed Van Camp B, Durie B, Spier C, De Waele M, Van Riet I, Vela E, Frutiger Y, Richter L, Grogan T: Plasma cells in multiple myeloma express a natural killer cell- associated antigen: CD56 (NKH-1; Leu-19). Blood. 1990, 76: 377-382.PubMed
15.
go back to reference Pellat-Deceunynck C, Bataille R, Robillard N, Harousseau J, Rapp M, Juge-Morineau N, Wijdenes J, Amiot M: Expression of CD28 and CD40 in human myeloma cells: a comparative study with normal plasma cells. Blood. 1994, 84: 2597-2603.PubMed Pellat-Deceunynck C, Bataille R, Robillard N, Harousseau J, Rapp M, Juge-Morineau N, Wijdenes J, Amiot M: Expression of CD28 and CD40 in human myeloma cells: a comparative study with normal plasma cells. Blood. 1994, 84: 2597-2603.PubMed
16.
go back to reference Pellat-Deceunynck C, Barillé S, Puthier D, Rapp M-J, Harousseau J-L, Bataille R, Amiot M: Adhesion Molecules on Human Myeloma Cells: Significant Changes in Expression Related to Malignancy, Tumor Spreading, and Immortalization. Cancer Research. 1995, 55: 3647-3653.PubMed Pellat-Deceunynck C, Barillé S, Puthier D, Rapp M-J, Harousseau J-L, Bataille R, Amiot M: Adhesion Molecules on Human Myeloma Cells: Significant Changes in Expression Related to Malignancy, Tumor Spreading, and Immortalization. Cancer Research. 1995, 55: 3647-3653.PubMed
17.
go back to reference Kouno T, Watanabe T, Umeda T, Beppu Y, Kojima R, Sungwon K, Kobayashi Y, Tobinai K, Hasegawa T, Matsuno Y: CD56-positive Small Round Cell Tumor: Osseous Plasmacytoma Manifested in Osteolytic Tumors of the Iliac Bone and Femora. Japanese Journal of Clinical Oncology. 2005, 35: 90-93.CrossRefPubMed Kouno T, Watanabe T, Umeda T, Beppu Y, Kojima R, Sungwon K, Kobayashi Y, Tobinai K, Hasegawa T, Matsuno Y: CD56-positive Small Round Cell Tumor: Osseous Plasmacytoma Manifested in Osteolytic Tumors of the Iliac Bone and Femora. Japanese Journal of Clinical Oncology. 2005, 35: 90-93.CrossRefPubMed
18.
go back to reference Camerini D, Walz G, Loenen W, Borst J, Seed B: The T cell activation antigen CD27 is a member of the nerve growth factor/tumor necrosis factor receptor gene family. The Journal of Immunology. 1991, 147: 3165-3169.PubMed Camerini D, Walz G, Loenen W, Borst J, Seed B: The T cell activation antigen CD27 is a member of the nerve growth factor/tumor necrosis factor receptor gene family. The Journal of Immunology. 1991, 147: 3165-3169.PubMed
19.
go back to reference Goodwin RG, Alderson MR, Smith CA, Armitage RJ, VandenBos T, Jerzy R, Tough TW, Schoenborn MA, Davis-Smith T, Hennen K, et al.: Molecular and biological characterization of a ligand for CD27 defines a new family of cytokines with homology to tumor necrosis factor. Cell. 1993, 73: 447-456.CrossRefPubMed Goodwin RG, Alderson MR, Smith CA, Armitage RJ, VandenBos T, Jerzy R, Tough TW, Schoenborn MA, Davis-Smith T, Hennen K, et al.: Molecular and biological characterization of a ligand for CD27 defines a new family of cytokines with homology to tumor necrosis factor. Cell. 1993, 73: 447-456.CrossRefPubMed
20.
go back to reference Maurer D, Holter W, Majdic O, Fischer GF, Knapp W: CD27 expression by a distinct subpopulation of human B lymphocytes. European Journal of Immunology. 1990, 20: 2679-2684.CrossRefPubMed Maurer D, Holter W, Majdic O, Fischer GF, Knapp W: CD27 expression by a distinct subpopulation of human B lymphocytes. European Journal of Immunology. 1990, 20: 2679-2684.CrossRefPubMed
21.
go back to reference Klein U, Rajewsky K, Küppers R: Human Immunoglobulin (Ig)M+IgD+ Peripheral Blood B Cells Expressing the CD27 Cell Surface Antigen Carry Somatically Mutated Variable Region Genes: CD27 as a General Marker for Somatically Mutated (Memory) B Cells. The Journal of Experimental Medicine. 1998, 188: 1679-1689.PubMedCentralCrossRefPubMed Klein U, Rajewsky K, Küppers R: Human Immunoglobulin (Ig)M+IgD+ Peripheral Blood B Cells Expressing the CD27 Cell Surface Antigen Carry Somatically Mutated Variable Region Genes: CD27 as a General Marker for Somatically Mutated (Memory) B Cells. The Journal of Experimental Medicine. 1998, 188: 1679-1689.PubMedCentralCrossRefPubMed
22.
go back to reference Tangye SG, Liu Y-J, Aversa G, Phillips JH, de Vries JE: Identification of Functional Human Splenic Memory B Cells by Expression of CD148 and CD27. The Journal of Experimental Medicine. 1998, 188: 1691-1703.PubMedCentralCrossRefPubMed Tangye SG, Liu Y-J, Aversa G, Phillips JH, de Vries JE: Identification of Functional Human Splenic Memory B Cells by Expression of CD148 and CD27. The Journal of Experimental Medicine. 1998, 188: 1691-1703.PubMedCentralCrossRefPubMed
23.
go back to reference Lens SMA, Jong RD, Hintzen RQ, Koopman G, Van Lier RAW, Van Oers RHJ: CD27-CD70 Interaction: Unravelling its Implication in Normal and Neoplastic B-Cell Growth. Leukemia & Lymphoma. 1995, 18: 51-59.CrossRef Lens SMA, Jong RD, Hintzen RQ, Koopman G, Van Lier RAW, Van Oers RHJ: CD27-CD70 Interaction: Unravelling its Implication in Normal and Neoplastic B-Cell Growth. Leukemia & Lymphoma. 1995, 18: 51-59.CrossRef
24.
go back to reference Agematsu K, Hokibara S, Nagumo H, Komiyama A: CD27: a memory B-cell marker. Immunology Today. 2000, 21: 204-206.CrossRefPubMed Agematsu K, Hokibara S, Nagumo H, Komiyama A: CD27: a memory B-cell marker. Immunology Today. 2000, 21: 204-206.CrossRefPubMed
25.
go back to reference Farstad IN, Carlsen H, Morton HC, Brandtzaeg P: Immunoglobulin A cell distribution in the human small intestine: phenotypic and functional characteristics. Immunology. 2000, 101: 354-363.PubMedCentralCrossRefPubMed Farstad IN, Carlsen H, Morton HC, Brandtzaeg P: Immunoglobulin A cell distribution in the human small intestine: phenotypic and functional characteristics. Immunology. 2000, 101: 354-363.PubMedCentralCrossRefPubMed
26.
go back to reference Jung J, Choe J, Li L, Choi YS: Regulation of CD27 expression in the course of germinal center B cell differentiation: the pivotal role of IL-10. European Journal of Immunology. 2000, 30: 2437-2443.CrossRefPubMed Jung J, Choe J, Li L, Choi YS: Regulation of CD27 expression in the course of germinal center B cell differentiation: the pivotal role of IL-10. European Journal of Immunology. 2000, 30: 2437-2443.CrossRefPubMed
27.
go back to reference Zhan F, Hardin J, Kordsmeier B, Bumm K, Zheng M, Tian E, Sanderson R, Yang Y, Wilson C, Zangari M, et al.: Global gene expression profiling of multiple myeloma, monoclonal gammopathy of undetermined significance, and normal bone marrow plasma cells. Blood. 2002, 99: 1745-1757.CrossRefPubMed Zhan F, Hardin J, Kordsmeier B, Bumm K, Zheng M, Tian E, Sanderson R, Yang Y, Wilson C, Zangari M, et al.: Global gene expression profiling of multiple myeloma, monoclonal gammopathy of undetermined significance, and normal bone marrow plasma cells. Blood. 2002, 99: 1745-1757.CrossRefPubMed
28.
go back to reference Katayama Y, Sakai A, Oue N, Asaoku H, Otsuki T, Shiomomura T, Masuda R, Hino N, Takimoto Y, Imanaka F, et al.: A possible role for the loss of CD27-CD70 interaction in myelomagenesis. British Journal of Haematology. 2003, 120: 223-234.CrossRefPubMed Katayama Y, Sakai A, Oue N, Asaoku H, Otsuki T, Shiomomura T, Masuda R, Hino N, Takimoto Y, Imanaka F, et al.: A possible role for the loss of CD27-CD70 interaction in myelomagenesis. British Journal of Haematology. 2003, 120: 223-234.CrossRefPubMed
29.
go back to reference Moreau P, Robillard N, Jégo G, Pellat C, Gouill SL, Thoumi S, Avet-Loiseau H, Harousseau J-L, Bataille R: Lack of CD27 in myeloma delineates different presentation and outcome. British Journal of Haematology. 2006, 132: 168-170.CrossRefPubMed Moreau P, Robillard N, Jégo G, Pellat C, Gouill SL, Thoumi S, Avet-Loiseau H, Harousseau J-L, Bataille R: Lack of CD27 in myeloma delineates different presentation and outcome. British Journal of Haematology. 2006, 132: 168-170.CrossRefPubMed
30.
go back to reference Guikema JEJ, Hovenga S, Vellenga E, Conradie JJ, Abdulahad WH, Bekkema R, Smit JW, Zhan F, Shaughnessy J, Bos NA: CD27 is heterogeneously expressed in multiple myeloma: low CD27 expression in patients with high-risk disease. British Journal of Haematology. 2003, 121: 36-43.CrossRefPubMed Guikema JEJ, Hovenga S, Vellenga E, Conradie JJ, Abdulahad WH, Bekkema R, Smit JW, Zhan F, Shaughnessy J, Bos NA: CD27 is heterogeneously expressed in multiple myeloma: low CD27 expression in patients with high-risk disease. British Journal of Haematology. 2003, 121: 36-43.CrossRefPubMed
31.
go back to reference Degrassi A, Hilbert DM, Rudikoff S, Anderson AO, Potter M, Coon HG: In vitro culture of primary plasmacytomas requires stromal cell feeder layers. Proceedings of the National Academy of Sciences. 1993, 90: 2060-2064.CrossRef Degrassi A, Hilbert DM, Rudikoff S, Anderson AO, Potter M, Coon HG: In vitro culture of primary plasmacytomas requires stromal cell feeder layers. Proceedings of the National Academy of Sciences. 1993, 90: 2060-2064.CrossRef
32.
go back to reference Okada T, Hawley RG: Adhesion molecules involved in the binding of murine myeloma cells to bone marrow stromal elements. International Journal of Cancer. 1995, 63: 823-830.CrossRef Okada T, Hawley RG: Adhesion molecules involved in the binding of murine myeloma cells to bone marrow stromal elements. International Journal of Cancer. 1995, 63: 823-830.CrossRef
33.
go back to reference Asosingh K, Günthert U, Bakkus MHC, De Raeve H, Goes E, Van Riet I, Van Camp B, Vanderkerken K: In Vivo Induction of Insulin-like Growth Factor-I Receptor and CD44v6 Confers Homing and Adhesion to Murine Multiple Myeloma Cells. Cancer Research. 2000, 60: 3096-3104.PubMed Asosingh K, Günthert U, Bakkus MHC, De Raeve H, Goes E, Van Riet I, Van Camp B, Vanderkerken K: In Vivo Induction of Insulin-like Growth Factor-I Receptor and CD44v6 Confers Homing and Adhesion to Murine Multiple Myeloma Cells. Cancer Research. 2000, 60: 3096-3104.PubMed
34.
go back to reference Lokhorst H, Lamme T, de Smet M, Klein S, de Weger R, van Oers R, Bloem A: Primary tumor cells of myeloma patients induce interleukin-6 secretion in long-term bone marrow cultures. Blood. 1994, 84: 2269-2277.PubMed Lokhorst H, Lamme T, de Smet M, Klein S, de Weger R, van Oers R, Bloem A: Primary tumor cells of myeloma patients induce interleukin-6 secretion in long-term bone marrow cultures. Blood. 1994, 84: 2269-2277.PubMed
35.
go back to reference UG: CD44: a multitude of isoforms with diverse functions. Anglais. 1993, 184: 47-63. UG: CD44: a multitude of isoforms with diverse functions. Anglais. 1993, 184: 47-63.
36.
go back to reference Liebisch P, Eppinger S, Schopflin C, Stehle G, Munzert G, Dohner H, Schmid M: CD44v6, a target for novel antibody treatment approaches, is frequently expressed in multiple myeloma and associated with deletion of chromosome arm 13q. Haematologica. 2005, 90: 489-493.PubMed Liebisch P, Eppinger S, Schopflin C, Stehle G, Munzert G, Dohner H, Schmid M: CD44v6, a target for novel antibody treatment approaches, is frequently expressed in multiple myeloma and associated with deletion of chromosome arm 13q. Haematologica. 2005, 90: 489-493.PubMed
37.
go back to reference Eisterer W, Bechter O, Hilbe W, van Driel M, Lokhorst HM, Thaler J, Bloem AC, Günthert U, Stauder R: CD44 isoforms are differentially regulated in plasma cell dyscrasias and CD44v9 represents a new independent prognostic parameter in multiple myeloma. Leukemia Research. 2001, 25: 1051-1057.CrossRefPubMed Eisterer W, Bechter O, Hilbe W, van Driel M, Lokhorst HM, Thaler J, Bloem AC, Günthert U, Stauder R: CD44 isoforms are differentially regulated in plasma cell dyscrasias and CD44v9 represents a new independent prognostic parameter in multiple myeloma. Leukemia Research. 2001, 25: 1051-1057.CrossRefPubMed
Metadata
Title
Extraosseous (extramedullary) plasmacytomas: a clinicopathologic and immunophenotypic study of 32 Chinese cases
Authors
Zhuo Zuo
Yuan Tang
Cheng-Feng Bi
Wen-Yan Zhang
Sha Zhao
Xiao-Qing Wang
Qun-Pei Yang
Li-Qun Zou
Wei-Ping Liu
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Diagnostic Pathology / Issue 1/2011
Electronic ISSN: 1746-1596
DOI
https://doi.org/10.1186/1746-1596-6-123

Other articles of this Issue 1/2011

Diagnostic Pathology 1/2011 Go to the issue