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Aberrant Acquisition of T-cell Associated Markers in Plasma Cell Neoplasms: An Aggressive Disease with Extramedullary Involvement and Very Short Survival. Mediterr J Hematol Infect Dis 2021; 13:e2021043. [PMID: 34276912 PMCID: PMC8265333 DOI: 10.4084/mjhid.2021.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/07/2021] [Indexed: 11/08/2022] Open
Abstract
Background Plasma cell neoplasms can show aberrant expression of different lineage-related antigens; however, co-expression of T-cell-associated markers on malignant plasma cells is extremely rare. Material and methods This report describes clinicopathologic characteristics of three myeloma patients with emergent plasmablastic morphology and aberrant acquisition of T-cell-associated markers diagnosed in our center. An extensive literature search for similar cases was conducted, and the relevant pathologic, clinical, and prognostic characteristics were summarized. Results A total of 22 cases of plasma cell neoplasm (including the three cases reported here) showed aberrant co-expression of T-cell markers. We found an evident association between aberrant expression of T-cell markers on malignant plasma cells and extramedullary involvement, aggressive morphologic features, high proliferative index ki67 >90%, aggressive clinical course, an adverse outcome, and short survival. Discussion & Conclusion Due to the rarity of this aberrant phenotype and scarcity of the published data, the precise causative mechanism and its clinical implications have not yet been elucidated.
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Chakraborty R, Lentzsch S. Prognostic impact of t(11;14) in multiple myeloma: Black and white or shades of gray? Cancer 2021; 127:31-34. [PMID: 32966668 DOI: 10.1002/cncr.33206] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/08/2020] [Accepted: 08/10/2020] [Indexed: 01/18/2023]
Affiliation(s)
- Rajshekhar Chakraborty
- Multiple Myeloma and Amyloidosis Service, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York
| | - Suzanne Lentzsch
- Multiple Myeloma and Amyloidosis Service, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York
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Elsabah H, Soliman DS, Ibrahim F, Al-Sabbagh A, Yassin M, Moustafa A, Nashwan AM, Nawaz Z, ElOmri HM. Plasma Cell Myeloma with an Aggressive Clinical Course and Anaplastic Morphology in a 22-Year-Old Patient: A Case Report and Review of Literature. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e920489. [PMID: 32152261 PMCID: PMC7081950 DOI: 10.12659/ajcr.920489] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 01/28/2020] [Accepted: 11/26/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Plasma cell myeloma is a neoplastic plasma cell disorder that usually presents after the fifth decade of life; it is rarely described in younger population especially under 30 years of age. However, there are conflicting reports in the literature about the clinical behavior and overall survival in younger age groups. In approximately 2% of plasma cell myeloma, the morphology of the neoplastic cells is highly pleomorphic, quite anaplastic, and may resemble metastatic tumor cells. While this poses a challenge for morphological interpretation during diagnosis, it has been demonstrated that bone marrow morphologic features (including diffuse sheet growth pattern, immature cell morphology and high mitotic index) significantly correlates with high risk disease. Moreover, there is limited description available about the morphology of the neoplastic cells when correlating the age at presentation with the clinical outcome/biological behavior; hence, the need to report and collect such cases. CASE REPORT We report a case of plasma cell myeloma in a 22-year-old male who presented with non-specific clinical features and posed a diagnostic challenge during clinical, radiological, and laboratory examination. The pathology specimens showed anaplastic morphology. Unfortunately, after diagnosis, despite treatment with brotezomib, his disease had an aggressive clinical course and he passed away 4 months after diagnosis. CONCLUSIONS Although plasma cell myeloma is rare in patients younger than 30 years, it must be considered in the differential diagnosis and investigated properly especially in patients with clinical suspicion of a metastatic non-hematological tumor. The anaplastic variant in a young patient is a diagnostic challenge and is associated with bizarre morphology, aggressive presentation, adverse cytogenetics, resistance to chemotherapy, and poor, short-term, survival.
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Affiliation(s)
- Hesham Elsabah
- Department of Medical Oncology, National Center for Cancer Care and Research(NCCCR), Hamad Medical Corporation, Doha, Qatar
| | - Dina S. Soliman
- Department of Laboratory Medicine and Pathology, National Centre for Cancer Care and Research (NCCCR), Hamad Medical Corporation, Doha, Qatar
- Department of Laboratory Medicine and Pathology, Weill Cornell Medical College, Doha, Qatar
- Department of Clinical Pathology, National Cancer Institute, Cairo, Egypt
| | - Feryal Ibrahim
- Department of Laboratory Medicine and Pathology, National Centre for Cancer Care and Research (NCCCR), Hamad Medical Corporation, Doha, Qatar
| | - Ahmad Al-Sabbagh
- Department of Laboratory Medicine and Pathology, National Centre for Cancer Care and Research (NCCCR), Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Yassin
- Department of Medical Oncology, National Center for Cancer Care and Research(NCCCR), Hamad Medical Corporation, Doha, Qatar
| | - Abbas Moustafa
- Department of Radiology (Clinical Imaging), National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation, Doha, Qatar
| | - Abdulqadir M. Nashwan
- Cancer Clinical Trials Unit, Department of Medical Oncology, National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation, Doha, Qatar
| | - Zafar Nawaz
- Department of Laboratory Medicine and Pathology, National Centre for Cancer Care and Research (NCCCR), Hamad Medical Corporation, Doha, Qatar
| | - Halima M. ElOmri
- Department of Medical Oncology, National Center for Cancer Care and Research(NCCCR), Hamad Medical Corporation, Doha, Qatar
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