Primary extramedullary plasmacytoma and multiple myeloma:: phenotypic differences revealed by immunohistochemical analysis
Primary extramedullary plasmacytoma and multiple myeloma:: phenotypic differences revealed by immunohistochemical analysis
复制标题
DOI：
10.1002/path.1680
复制
发表时间：
2005-01-01
影响因子：
7.3
通讯作者：
Fend, F
中科院分区：
文献类型：
--
作者：
Kremer, M;Ott, G;Fend, F
原发性髓外浆细胞瘤是一种罕见的，典型的孤立性浆细胞肿瘤，通常追求一个无痛的临床过程，但可能，很少，转换为多发性骨髓瘤。这两个实体之间的表型差异还没有很好的定义。分析了28例原发性髓外浆细胞瘤和26例髓内（n = 17）和髓外（n = 9）多发性骨髓瘤中已知在多发性骨髓瘤生物学中发挥作用的蛋白质的表达。免疫组织化学在石蜡切片上使用针对细胞周期蛋白D1、Bcl-2、BclxL、p27、p21、p53、MIB 1、CD 20和CD 56的抗体进行。23例髓外浆细胞瘤位于上呼吸消化道，4例位于淋巴结，1例位于睾丸。男性占绝对优势（男：女= 6：1）。无患者死于该病或进展为多发性骨髓瘤（平均随访50个月）。9名患者出现局部复发，1名患者的肿瘤演变为B细胞非霍奇金淋巴瘤。与髓内和髓外多发性骨髓瘤相比，髓外浆细胞瘤缺乏细胞周期蛋白D1（P < 0.001），很少表达CD 56（P < 0.001）。此外，髓外浆细胞瘤的特点是Bcl-2蛋白染色较弱，p21和p53过表达罕见。与髓外多发性骨髓瘤相比，髓外浆细胞瘤表现出更成熟的形态和较低的增殖指数（P = 0.008）。研究的表型参数与髓外浆细胞瘤的临床结果之间没有相关性。总之，髓外浆细胞瘤和多发性骨髓瘤显示出显著的免疫表型差异，其中一些可能具有诊断实用性和生物学相关性。版权所有（C）2004大不列颠和爱尔兰病理学会。出版社：John Wiley Sons，Ltd
Primary extramedullary plasmacytomas are infrequent, typically solitary, plasma cell neoplasms that generally pursue an indolent clinical course but may, rarely, convert to multiple myeloma. Phenotypic differences between these two entities are not well defined. Twenty-eight cases of primary extramedullary plasmacytoma and 26 cases of both medullary (n = 17) and extramedullary (n = 9) multiple myeloma were analysed for the expression of proteins known to play a role in the biology of multiple myeloma. Immunohistochernistry was performed on paraffin wax sections using antibodies against cyclin D1, Bcl-2, BclxL, p27, p21, p53, MIB1, CD20, and CD56. Twenty-three extramedullary plasmacytomas were localized in the upper aerodigestive tract, four in the lymph nodes, and one in the testis. There was a strong male predominance (M : F = 6: 1). None of the patients died from the disease or progressed to multiple myeloma (mean follow-up 50 months). Nine patients developed local relapse and one patient's tumour evolved into a B-cell non-Hodgkin's lymphoma. In contrast to both intra- and extra-medullary multiple myeloma, extramedullary plasmacytoma showed absence of cyclin D1 (P < 0.001) and infrequent expression of CD56 (p < 0.001). Furthermore, extramedullary plasmacytomas were characterized by weaker staining for Bcl-2 protein and rare overexpression of p21 and p53. In comparison to extramedullary multiple myeloma, extramedullary plasmacytoma showed a more mature morphology and lower proliferation indices (P = 0.008). There was no association between the phenotypic parameters investigated and clinical outcome in extramedullary plasmacytoma. In summary, extramedullary plasmacytoma and multiple myeloma show significant immunophenotypic differences, some of which may be of both diagnostic utility and biological relevance. Copyright (C) 2004 Pathological Society of Great Britain and Ireland. Published by John Wiley Sons, Ltd.