Chilosi M, Adami F, Lestani M, Montagna L, Cimarosto L, Semenzato G, Pizzolo G, Menestrina F
Department of Pathology, University of Verona, Italy.
Mod Pathol. 1999 Dec;12(12):1101-6.
Detection of abnormal numbers and/or distribution of bone marrow (BM) plasma cells (PCs) on trephine biopsies can be important in the differential diagnosis of multiple myeloma (MM) and other PC disorders. A variety of immunohistochemical markers can potentially improve the specificity and sensitivity of PC detection on routine histological sections obtained from trephine BM biopsies, but most of them are not completely satisfactory. In this study, we investigated whether the antibody CD138/B-B4, which is an optimal marker for PC detection on BM aspirates by flow cytometry, can be used successfully for the identification of PCs also on formalin-fixed, decalcified biopsies. A series of samples including normal BM [12], MM [65], monoclonal gammopathies of undetermined significance [44], and B-cell lymphoma of various types [94], including B-cell precursor lymphoblastic leukemia [9], lymphoplasmacytoid [17], immunoblastic [14], lymphocytic/CLL [23], hairy cell leukemia [4], large B-cell [8], mantle-cell [3], marginal zone [6] and follicular [10] lymphomas, have been investigated for CD138 expression using a sensitive immunohistochemical technique. Within the BM microenvironment, CD138 was characterized by excellent sensitivity and specificity. Virtually all normal and neoplastic PCs expressed clear-cut membrane CD138 immunostaining, whereas all other cell types did not. All cases of MM, including plasmablastic and leukemic cases, showed strong immunoreactivity. Conversely, all B-cell lymphomas, including all cases characterized by secretive features, lymphoplasmacytoid, and immunoblastic lymphomas, were completely negative. These results demonstrate that CD138 is a highly sensitive and specific marker that is useful for the rapid and precise localization of normal and neoplastic PCs on routine BM sections. In addition, because of its clear-cut cell membrane localization, CD138 can be used successfully in double-marker immunostaining reactions to evaluate precisely nuclear prognostic markers such as Ki67 and p53 in MMs.
在骨髓活检切片上检测骨髓（BM）浆细胞（PCs）数量异常和/或分布异常，对多发性骨髓瘤（MM）及其他PC疾病的鉴别诊断可能具有重要意义。多种免疫组化标志物可能会提高从骨髓活检切片获得的常规组织学切片上PC检测的特异性和敏感性，但其中大多数并不完全令人满意。在本研究中，我们调查了抗体CD138/B - B4（它是通过流式细胞术检测骨髓穿刺液中PC的最佳标志物）是否也能成功用于福尔马林固定、脱钙活检组织中PC的鉴定。我们使用一种敏感的免疫组化技术，对一系列样本进行了CD138表达情况的研究，这些样本包括正常骨髓（12例）、MM（65例）、意义未明的单克隆丙种球蛋白病（44例）以及各种类型的B细胞淋巴瘤（94例），其中包括B细胞前体淋巴细胞白血病（9例）、淋巴浆细胞样（17例）、免疫母细胞性（14例）、淋巴细胞性/慢性淋巴细胞白血病（23例）、毛细胞白血病（4例）、大B细胞（8例）、套细胞（3例）、边缘区（6例）和滤泡性（10例）淋巴瘤。在骨髓微环境中，CD138表现出极佳的敏感性和特异性。几乎所有正常和肿瘤性PCs均表达清晰的细胞膜CD138免疫染色，而所有其他细胞类型均不表达。所有MM病例，包括浆母细胞性和白血病性病例，均表现出强免疫反应性。相反，所有B细胞淋巴瘤，包括所有具有分泌特征、淋巴浆细胞样和免疫母细胞性淋巴瘤特征的病例，均完全阴性。这些结果表明，CD138是一种高度敏感和特异的标志物，可用于在常规骨髓切片上快速、精确地定位正常和肿瘤性PCs。此外，由于其清晰的细胞膜定位，CD138可成功用于双标志物免疫染色反应，以精确评估MM中诸如Ki67和p53等核预后标志物。
