A Plasma Cell Myeloma With Post-Therapy Anaplastic Morphology, Osteomyelosclerosis, and Strong Pan-Cytokeratin (AE1/AE3) Expression: A Potential Diagnostic Pitfall

Bharani, Vani; Sharma, Prashant; Bal, Amanjit; Prakash, Gaurav

doi:10.1177/1066896917750472

Cited by 2 publications

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References 8 publications

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“…A previous studies showed expression of cytokeratins is a very rare phenomenon in DLBCL (2 of 326, 0.6%) 14 . The staining pattern is similar to previous reports in DLBCL, anaplastic large cell lymphoma, plasma cell myeloma, and plasmablastic lymphoma 13‐19 . Plasma cell myeloma and Hodgkin's lymphoma showed intensive cytoplasmic staining 14 .…”

Section: Discussionsupporting

confidence: 89%

Aberrant expression of TTF1, p63, and cytokeratins in a diffuse large B‐cell lymphoma

Chornenkyy

Lin

2020

Diagnostic Cytopathology

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Pancytokeratins and TTF‐1 are used in working up carcinomas of unknown primary and p63 is expressed in many cell lineages. We present a case of a TTF‐1, p63, and cytokeratins positive small round blue cell lesion presenting in a patient with enlarged right supraclavicular lymph nodes and multiple solid pulmonary nodules. The preliminary report to the clinical team was “suspicious for carcinoma.” However, after a complete work up the final diagnosis of diffuse large B‐cell lymphoma, nongerminal center B‐cell phenotype, “double expressor,” was rendered (based on Han's algorithm). This case brings up significant diagnostic dilemma as some lymphoid malignancies can morphologically mimic poorly differentiated carcinoma and stain positive for carcinoma markers. Additionally, the frequently used TTF‐1 SPT23 antibody clone has strong nuclear staining in rare cases of DLBCL, which is a diagnostic pitfall. To our best knowledge this is the first reported case of DLBCL staining positive for three carcinoma markers.

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Section: Discussionsupporting

confidence: 89%

Aberrant expression of TTF1, p63, and cytokeratins in a diffuse large B‐cell lymphoma

Chornenkyy

Lin

2020

Diagnostic Cytopathology

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“…Myeloma can pose morphological challenges [2]. Small lymphocytic morphology is rare and may carry a better prognosis [3].…”

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confidence: 99%

Plasma cell leukemia masquerading as lymphoplasmacytic lymphoma: a diagnostic challenge

et al. 2019

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Dear Editor,We read with interest the case report by Larson et al. [1] in the Journal of Hematopathology and would like to share a similarly challenging case of plasma cell leukemia encountered in a young patient at our center.A 36-year-old lady presented with a history of backache and generalized weakness for 3 months. She had severe pallor; however, there was no localized bony tenderness, lymphadenopathy, or organomegaly. Investigations revealed hemoglobin 51 g/L (reference range 120-160 g/L), total leukocyte count 243 × 10 9 /L (reference range 4-11 × 10 9 /L), and platelets 119 × 10 9 /L (reference range 150-400 × 10 9 /L). A peripheral blood smear showed marked lymphocytosis with absolute lymphocyte count of 206.6 × 10 9 /L (reference range 1.0-4.0 × 10 9 /L) and 3% cells showing lymphoplasmacytic morphology ( Fig. 1, left image). Biochemistry revealed normal renal function, albumin-corrected serum calcium (10.3 mg/ dL, reference range 9-11 mg/dL), and elevated lactate dehydrogenase (375 U/L, reference range 140-271 U/L). There was marked hypergammaglobulinemia and serum protein electrophoresis identified a monoclonal band (5.6 g/dl). Urine protein electrophoresis and immunofixation did not reveal an M-band and Bence Jones proteins were undetectable. Serum-free light chain assay showed κ = 12,400 mg/L (reference range 3.3-19.4 mg/L), λ = 6.11 mg/L (5.7-26.3 mg/L) with κ/λ ratio = 2029.46 (reference range 0.26-1.65). Bone marrow aspiration revealed massive infiltration by small * Prashant Sharma

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A Plasma Cell Myeloma With Post-Therapy Anaplastic Morphology, Osteomyelosclerosis, and Strong Pan-Cytokeratin (AE1/AE3) Expression: A Potential Diagnostic Pitfall

Cited by 2 publications

References 8 publications

Aberrant expression of TTF1, p63, and cytokeratins in a diffuse large B‐cell lymphoma

Aberrant expression of TTF1, p63, and cytokeratins in a diffuse large B‐cell lymphoma

Plasma cell leukemia masquerading as lymphoplasmacytic lymphoma: a diagnostic challenge

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