Linden M D, Fishleder A J, Tubbs R R, Park H
Department of Pathology, Cleveland Clinic Foundation, Ohio 44106.
Cancer. 1989 Mar 1;63(5):859-62. doi: 10.1002/1097-0142(19890301)63:5<859::aid-cncr2820630511>3.0.co;2-b.
Four cases of plasma cell leukemia (PCL) are reported that illustrate the variable immunotype of this disorder in contrast with the immunologic profile described for normal B-cell maturation and typical multiple myeloma (MM). Mature B-lymphocytes express B1 antigen (Ag) and surface immunoglobulin (SIg) whereas maturation to the plasma cell stage is accompanied by loss of these immunologic markers and expression of T10 Ag, plasma cell Ag (PCA), and cytoplasmic immunoglobulin (CIg). Plasma cells from patients with MM have previously been found to express the immunophenotype of normal plasma cells. In contrast, none of the four cases reported here express an immunologic profile typical for specific B-cell differentiation stages. Only one of four cases was strongly positive for PCA but additionally expressed B1 Ag and SIg. Of the remaining three cases, all expressed T10 Ag and CIg; two cases also expressed SIg, weak PCA, and B1 Ag. All four cases were monoclonal for lambda light chains and negative for common ALL Ag (CALLA). The variable expression of mature B-cell markers and plasma cell markers demonstrates the immunophenotypic spectrum of PCL; the prognostic significance of this heterogeneity needs to be more closely examined.
本文报告了4例浆细胞白血病（PCL）病例，这些病例显示了该疾病免疫表型的多样性，与正常B细胞成熟及典型多发性骨髓瘤（MM）所描述的免疫特征形成对比。成熟B淋巴细胞表达B1抗原（Ag）和表面免疫球蛋白（SIg），而向浆细胞阶段的成熟伴随着这些免疫标志物的丧失以及T10 Ag、浆细胞抗原（PCA）和细胞质免疫球蛋白（CIg）的表达。先前发现MM患者的浆细胞表达正常浆细胞的免疫表型。相比之下，本文报告的4例病例均未表达特定B细胞分化阶段典型的免疫特征。4例病例中仅1例PCA呈强阳性，但还表达B1 Ag和SIg。其余3例均表达T10 Ag和CIg；2例还表达SIg、弱PCA和B1 Ag。所有4例病例的λ轻链均为单克隆性，常见急性淋巴细胞白血病抗原（CALLA）为阴性。成熟B细胞标志物和浆细胞标志物的可变表达显示了PCL的免疫表型谱；这种异质性的预后意义需要更深入地研究。
