Department of Pathology, Northwestern University-Feinberg School of Medicine, Chicago, IL 60611, USA.
Am J Clin Pathol. 2013 Feb;139(2):210-9. doi: 10.1309/AJCP0YGM8BLFYHJY.
Waldenström macroglobulinemia (WM) is characterized by monoclonal gammopathy, usually IgM, in association with lymphoplasmacytic lymphoma (LPL). Little is known of the expression of nuclear proteins involved in B-cell development in LPL/WM. In this study, the expression patterns of PAX5/BSAP, MUM1/IRF4, and PRDM1/BLIMP1 were analyzed in plasma cells and lymphocytes in 29 cases of newly diagnosed LPL/WM by double immunohistochemical staining with CD138 and CD22. These patterns were compared with the expression profiles seen in normal bone marrow samples, reactive tonsils, and cases of plasma cell myeloma and marginal zone lymphoma. The median percentage of plasma cells coexpressing CD138 and PAX5 was significantly higher in LPL/WM compared with benign tissues (P = .001), marginal zone lymphoma (P = .002), and plasma cell myeloma (P < .0001), whereas the median percentage of plasma cells coexpressing CD138 and MUM1 was lower in LPL/WM than plasma cells in benign tissues (P = .02), marginal zone lymphoma (P = .001), and plasma cell myeloma (P = .0002). These findings show that a subset of plasma cells in LPL/WM demonstrates a nuclear protein expression pattern characteristic of the B-cell developmental program. Thus, the results better define the immunophenotypic profile of the neoplastic cells in LPL/WM.
华氏巨球蛋白血症（WM）的特征是单克隆丙种球蛋白病，通常为 IgM，与淋巴浆细胞淋巴瘤（LPL）相关。在 LPL/WM 中，与 B 细胞发育相关的核蛋白的表达情况知之甚少。在这项研究中，通过双重免疫组织化学染色用 CD138 和 CD22 分析了 29 例新诊断的 LPL/WM 中浆细胞和淋巴细胞中的 PAX5/BSAP、MUM1/IRF4 和 PRDM1/BLIMP1 的表达模式。将这些模式与正常骨髓样本、反应性扁桃体和浆细胞骨髓瘤和边缘区淋巴瘤的表达谱进行了比较。与良性组织（P =.001）、边缘区淋巴瘤（P =.002）和浆细胞骨髓瘤（P <.0001）相比，LPL/WM 中共同表达 CD138 和 PAX5 的浆细胞的中位数百分比明显更高，而 LPL/WM 中共同表达 CD138 和 MUM1 的浆细胞的中位数百分比则低于良性组织（P =.02）、边缘区淋巴瘤（P =.001）和浆细胞骨髓瘤（P =.0002）中的浆细胞。这些发现表明，LPL/WM 中的一部分浆细胞表现出与 B 细胞发育程序特征一致的核蛋白表达模式。因此，结果更好地定义了 LPL/WM 中肿瘤细胞的免疫表型特征。
