骨孤立性浆细胞瘤病例表现为两种免疫球蛋白轻链的共表达。
A case of solitary plasmacytoma of bone showing co-expression of both immunoglobulin light chains.
机构信息
Department of Diagnostic Pathology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan.
Department of Hematology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan.
出版信息
Eur J Med Res. 2021 Dec 20;26(1):148. doi: 10.1186/s40001-021-00621-8.
BACKGROUND
Solitary plasmacytoma of bone (SPB) is a rare plasma cell neoplasm. It arises in bone as a single locus in the absence of any plasma cell myeloma lesions. Plasma cell neoplasms intrinsically express only one immunoglobulin light chain (IgL)-kappa or lambda-and using this fact, kappa/lambda deviation is the decisive factor for diagnosis. Co-expression of both IgLs in a single tumor cell is extremely rare.
CASE PRESENTATION
We report a case of SPB that arose in the vertebra of a 52-year-old Japanese woman. Histologically, the resected mass showed diffuse plasma cell proliferation. Dual IgL expression was detected by flow cytometry, immunohistochemistry, and in situ hybridization (ISH) targeting IgL mRNA.
CONCLUSION
We have presented an extremely rare case of SPB showing dual expression of kappa and lambda IgLs. This unusual case of plasma cell neoplasia might represent a possible exceptional example of failure of "IgL isotypic exclusion."
背景
孤立性骨浆细胞瘤（SPB）是一种罕见的浆细胞瘤。它在骨中作为单一病灶出现，没有任何浆细胞瘤病变。浆细胞瘤本质上仅表达一种免疫球蛋白轻链（IgL）-kappa 或 lambda-并利用这一事实，kappa/lambda 偏离是诊断的决定性因素。在单个肿瘤细胞中同时表达两种 IgL 极为罕见。
病例介绍
我们报告了一例发生在 52 岁日本女性椎骨中的 SPB 病例。组织学上，切除的肿块显示弥漫性浆细胞增殖。通过流式细胞术、免疫组织化学和针对 IgL mRNA 的原位杂交（ISH）检测到双重 IgL 表达。
结论
我们报告了一例极为罕见的同时表达 kappa 和 lambda IgL 的 SPB 病例。这种浆细胞瘤的异常病例可能代表了“IgL 同型排斥”失败的一个可能的特殊例子。
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