Anaplastic plasma cell myeloma — A morphological dilemma

Raman Ramalingam, Thulasi; Vaidhyanathan, Lakshman; Pandurangan, Prabu

doi:10.1016/j.htct.2020.06.013

Cited by 3 publications

(3 citation statements)

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“…Anaplastic myeloma cells have been described to have marked cytological atypia, pleomorphism, and loss of features which can help identify cell of origin. Therefore, diagnosis is heavily dependent on clinical history, morphology, and immunohistochemical stains [ 15 ]. They can mimic high-grade lymphoma or non-hematopoietic malignancy by morphology [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

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Cardiovascular Involvement of a CD138-Negative Anaplastic Myeloma: A Diagnostic Dilemma

et al. 2023

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Anaplastic myeloma (AM) is an extremely rare and aggressive histological variant of myeloma. It is characterized by extramedullary presentation in the young and has a poor prognosis. It can be a diagnostic challenge when myeloma is not suspected and even more when the immunophenotype is unexpected. We present a rare presentation of anaplastic myeloma with cardiovascular involvement. Though the patient did not have the typical clinical features of myeloma, except lytic lesion in the femur, the cardiac biopsy showed sheets of anaplastic cells, and some with multinucleation. There were also some areas with a more plasmacytoid appearance. The initial immunohistochemical panel was negative for CD3, CD20, CD138, AE1/3, and kappa. It was positive for lambda. This led to an extended panel which showed positivity for CD79a and MUM1 and negative for LMP-1, HHV-8, CD43, CD117, CD56, and CD30. Even the flow cytometry on the bone marrow showed a small population of atypical cells positive for CD38 and negative for CD138 with lambda restriction. This is an unusual case of anaplastic myeloma with cardiovascular involvement and CD138 negativity. This case highlights the need to add a panel of plasma cell markers when myeloma is suspected, and it is pertinent to read flow cytometry with caution to avoid missing atypical plasma cells which maybe CD38+/CD138−.

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Section: Discussionmentioning

confidence: 99%

“…Therefore, diagnosis is heavily dependent on clinical history, morphology, and immunohistochemical stains [ 15 ]. They can mimic high-grade lymphoma or non-hematopoietic malignancy by morphology [ 15 ]. The cells often resemble dysplastic megakaryocytes or giant cell osteoclasts [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Involvement of a CD138-Negative Anaplastic Myeloma: A Diagnostic Dilemma

et al. 2023

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“…Anaplastic morphology and resistance to conventional therapy are compatible with the unfavorable genetic abnormality observed in this case [ 1 ]. Anaplastic MM is characterized by pleomorphic and markedly enlarged plasma cells and poor clinical outcome [ 2 , 3 , 4 , 5 ]. The abnormal morphology can be confused with acute leukemia or aggressive lymphoma at the time of the initial diagnosis.…”

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confidence: 99%

The Many Faces of Multiple Myeloma

Bol¹,

Seval²,

Beksaç³

et al. 2024

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Anaplastic Multiple Myeloma: Case Series and Literature Review

Chu

Chase

et al. 2022

Asp Biomed Clin Case Rep

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Background: Anaplastic multiple myeloma (AMM) is a very rare but distinct subtype of multiple myeloma (MM) with an extremely poor prognosis. Due to its rarity, AMM lacks detailed descriptions and clear definitions. Moreover, there is no consensus on the treatment and evidence suggests that AMM responds poorly to several novel therapies. We conducted a literature review and retrospective case series to determine clinical characteristics, pathological features, and outcomes of AMM. Case Presentation: Published case reports and case series of AMM since 1983 were systematically extracted and reviewed. A total of 52 patients with AMM were reported in the PUBMED since 1983, including 26 males (50%) and 26 females (50%). The age ranged from 29 years old to 85 years old, with a mean age of 57.02 years old. Most of the patients presented with bone pain (23, 44.2%), fatigue (18, 34.6%), plasmacytoma (18, 34.6%) and weight loss (7, 13.5%). The median survival of the patients was 4 months. To investigate the outcomes of patients with AMM in the current era of treatment, a series of 14 patients with AMM diagnosed at our institute between December 2012 and July 2021was retrospectively analyzed. Our retrospective case series consisted of 12 males (85.7%) and 2 females (14.3%), with a mean age of 59 years old. Most of our AMM patients displayed bone lytic lesions as a common manifestation. The common cytogenetic abnormality was 1q amplification. All patients received standard combination chemotherapy consisting of proteasome inhibitors and/or immunomodulatory agents, and half of the patients underwent autologous hematopoietic stem cell transplantation. The median progression-free survival (PFS) and overall survival (OS) for our 14 AMM patients were 0.84 years and 1.52 years, respectively, which was significantly worse than the regular MM patients treated at our institute from 2003-2013 who had a PFS of 2.28 years and OS of 4.92 years. Conclusions: AMM is a very rare, morphologically distinct variant of MM. It has adverse cytogenetics and an aggressive course. It is often resistant to standard chemotherapy and presents with an extremely low survival rate.

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Anaplastic plasma cell myeloma — A morphological dilemma

Cited by 3 publications

References 3 publications

Cardiovascular Involvement of a CD138-Negative Anaplastic Myeloma: A Diagnostic Dilemma

Cardiovascular Involvement of a CD138-Negative Anaplastic Myeloma: A Diagnostic Dilemma

The Many Faces of Multiple Myeloma

Anaplastic Multiple Myeloma: Case Series and Literature Review

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