Aberrant acquisition of T-cell associated markers in plasma cell neoplasms: An aggressive disease with extramedullary involvement and very short survival

Abstract

Background:
 Plasma cell neoplasms can show aberrant expression of a different lineage-related antigens, however, co-expression of T-cell associated markers on malignant plasma cells is extremely rare.
 Material and methods: This is a report of clinicopathologic characteristics of three myeloma patients with emergent plasmablastic morphology and aberrant acquisition of T‐cell associated markers. 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, 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, adverse outcome with short survival.
 Conclusion:
 Due to rarity of this aberrant phenotype and scarcity of the published data, the precise causative mechanism and its clinical implications have not yet been elucidated.

Coexistence of ALK-negative anaplastic large T-cell lymphoma and plasmablastic lymphoma in the same patient: A case report

“…Interestingly, some PBL cases might aberrantly express T-cell markers, such as CD2, CD3, CD4, or CD7, a pitfall which might be the cause for an erroneous diagnosis of TCL [11]. This phenomenon has also been reported in plasmablastic myeloma (PBM), making the phenomenon of aberrant T-cell antigen expression unhelpful for the differential diagnosis between TCL, PBL and PBM [12].…”

Aberrant CD4 expression in plasmablastic transformation of multiple myeloma

“…PBM is an aggressive multiple myeloma subtype, with a poor prognosis. In addition to morphological transformation, aberrant T‐cell marker expression is useful for evaluating disease prognosis [ 1 ]. Although new‐class drugs and cytotoxic chemotherapy enable disease control in PBM, early treatment resistance in PBM with aberrant CD4 expression remains a clinical challenge.…”

A biphenotypic lymphocyte subset displays both T- and B-cell functionalities

“…Aberrant presence of Bcell-associated antigens such as CD20 and CD79a was observed in T-cell lymphomas 2,3 . Meanwhile, T-cell-associated antigens such as CD3, CD4, CD8, and CD5 were also detected in B-cell lymphomas 4,5 and plasma cell tumors 6,7 . CD3 + T cells carrying B-cell-associated marker (CD20) had also been observed in both healthy individuals and patients with immune dysregulation [8][9][10][11][12][13][14][15] .…”