Ahn Janice S, Okal Ryan, Vos Jeffrey A, Smolkin Matthew, Kanate Abraham S, Rosado Flavia G
Department of Pathology, West Virginia University, Morgantown, West Virginia, USA.
Department of Internal Medicine, West Virginia University, Morgantown, West Virginia, USA.
J Clin Pathol. 2017 Sep;70(9):775-780. doi: 10.1136/jclinpath-2016-204294. Epub 2017 Mar 1.
To determine the utility of clinical, morphological and phenotypical features in the differential diagnosis of plasmablastic lymphoma and myeloma with plasmablastic features.
All plasmablastic neoplasms identified from a 15-year retrospective search were reviewed and classified into 'lymphoma', 'myeloma' or 'indeterminate'. The classification was then compared with the previously established clinical diagnosis. Lessons learned from this review were used to design a diagnostic algorithm for pathologists to use in the absence of known clinical history.
The classification was possible in 10 of 11 cases, 8 lymphomas and 2 myelomas (n=2). No distinctive morphological or phenotypical features were identified. The most useful histopathological parameter was a positive Epstein-Barr virus in situ hybridisation. Presence of associated lymphadenopathy and/or oral mass in the absence of complete myeloma-defining signs was used to favour a diagnosis of lymphoma in 4 of 8 cases.
The distinction between plasmablastic lymphoma from plasmablastic myeloma warrants detailed knowledge of clinical, radiological and laboratorial findings. New studies identifying distinctive phenotypical or genetic features are needed to improve the histopathological differentiation of plasmablastic neoplasms.
确定临床、形态学和表型特征在浆母细胞淋巴瘤与具有浆母细胞特征的骨髓瘤鉴别诊断中的作用。
对15年回顾性研究中鉴定出的所有浆母细胞性肿瘤进行回顾，并分类为“淋巴瘤”、“骨髓瘤”或“不确定”。然后将该分类与先前确立的临床诊断进行比较。从该回顾中吸取的经验教训用于设计一种诊断算法，供病理学家在缺乏已知临床病史时使用。
11例中有10例可进行分类，8例淋巴瘤和2例骨髓瘤（n = 2）。未发现明显的形态学或表型特征。最有用的组织病理学参数是爱泼斯坦-巴尔病毒原位杂交阳性。在8例中的4例中，在无完整骨髓瘤定义体征的情况下，存在相关淋巴结病和/或口腔肿物有助于诊断淋巴瘤。
浆母细胞淋巴瘤与浆母细胞骨髓瘤的鉴别需要详细了解临床、放射学和实验室检查结果。需要新的研究来确定独特的表型或基因特征，以改善浆母细胞性肿瘤的组织病理学鉴别。
