Bone-marrow plasmocytosis ? An immunohistological study

Eckert, F.; Schmid, L; Kradolfer, Doris; Schmid, U

doi:10.1007/bf00320578

Cited by 17 publications

(17 citation statements)

References 17 publications

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“…However, these studies showed cIg LC restriction in patients with B-cell lymphoma and B-cell chronic lymphocytic leukemia but not in those with PCM. One report proposed threshold values for the ratio of cytoplasmic kappa to lambda LCs in PCs for detecting monoclonality in addition to listing criteria for discriminating between PCM and benign reactive plasmacytosis using immunohistological analyses [6]. That study determined the cytoplasmic kappa/lambda ratio in PCs to be 0.4–3.5 for reactive plasmacytosis and ≤0.1 or ≥11.2 for PCM.…”

Section: Discussionmentioning

confidence: 99%

An approach for diagnosing plasma cell myeloma by three-color flow cytometry based on kappa/lambda ratios of CD38-gated CD138+ cells

et al. 2012

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BackgroundWorld Health Organization (WHO) criteria are commonly used to diagnose plasma cell myeloma (PCM); however, these criteria are complex and require several laboratory parameters. For differentiating reactive plasmacytosis from clonal plasma cell (PC) neoplasms such as PCM, it is important to accurately determine the expression of cytoplasmic immunoglobulin light chains.MethodsWe retrospectively analyzed the records of 27 selected patients with PCM who underwent bone biopsies for confirmative diagnosis according to WHO criteria. Twenty-three controls were also investigated. In the present study, all the samples were analyzed using flow cytometry (FC) in the side scatter vs. CD38 histogram mode, and the CD38-gated PC population was identified. Bivariate histograms of CD138/kappa and CD138/lambda were assessed, and the ratios of dual-positive cells to the CD138+ PC population were calculated. The kappa/lambda ratio was defined as the ratio of CD138/kappa to CD138/lambda.ResultsPCM cells were distinguished from normal PCs using cutoff levels between 0.76 and 1.5, at a sensitivity of 96.3% and specificity of 95.7%.ConclusionsThree-color FC analysis is simple to perform and inexpensive, with clinically relevant data obtained soon after the completion of FC measurements. The detection of the cytoplasmic kappa/lambda ratio of CD38-gated CD138+ PCs may be a useful tool in the diagnosis of PCM. To the best of our knowledge, this report represents the first diagnostic assessment of the cytoplasmic kappa/lambda ratio in CD38-gated CD138+ PCs using FC analysis. This method may help in more simple, efficient, rapid, and accurate diagnosis of PCM.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1568085959771735

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Section: Discussionmentioning

confidence: 99%

An approach for diagnosing plasma cell myeloma by three-color flow cytometry based on kappa/lambda ratios of CD38-gated CD138+ cells

et al. 2012

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“…7 An immunohistological study determined the ratio of cytoplasmic κ to λ light chains in plasma cells to be 0.4-3.5 in reactive plasmacytosis, 0.2-3.0 in monoclonal gammopathy of unknown significance (MGUS), and < 0.2 or > 11.1 in multiple myeloma. 8 Although the cytoplasmic light chain ratio was useful in distinguishing multiple myeloma from MGUS and reactive plasmacytosis, the last two diagnoses were not always differentiated using this method. Rare cases of monoclonal gammopathy associated with crystal storage histiocytosis (CSH) may present problems in the differential diagnosis between plasma cell neoplasms and other causes of CSH, such as Gaucher's disease, rhabdomyoma, fibrosclerosis, and Weber-Christian disease.…”

Section: Diagnosis Of Plasma Cell Neoplasmsmentioning

confidence: 99%

Bone marrow immunohistology of plasma cell neoplasms

Wei

Juneja

2003

Journal of Clinical Pathology

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“…The kappa/lambda ratio was ... (2). A report proposed the threshold values for the ratio of cytoplasmic kappa to lambda LCs in plasma cells for detecting monoclonality, in addition to the criteria for discriminating between PCM and benign reactive plasmacytosis using immunohistological analyses (3) and determined that the cytoplasmic kappa/ lambda ratio in plasma cells was 0.4-3.5 in reactive plasmacytosis and~O.l or 2:11.2 in PCM. However, it did not show the decision limits of an abnonnal kappa/lambda ratio in the diagnostic process.…”

Section: Resultsmentioning

confidence: 99%

An Approach for Plasma Cell Myeloma Diagnosis by Two-Color Flow Cytometry Based on Kappa/Lambda Ratios of CD38-Gated Plasma Cells

Nakayama

Yokote

Hirata

et al. 2013

Int J Immunopathol Pharmacol

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Criteria from the World Health Organization (WHO) are commonly used to diagnose plasma cell myeloma (PCM), but they are complex and require several laboratory parameters. To differentiate reactive plasmacytosis from clonal plasma cell neoplasms, such as PCM, it is important to accurately determine the expression ofthe cytoplasmic immunoglobulin (cIg) light chain (LC). Through retrospective analyses, we selected the patients with PCM, and analyzed records of 52 PCM patients, who underwent bone biopsies, and final diagnosis ofPCM was established according to WHO criteria, and 22 controls. In the present study, all samples were analyzed by flow cytometry (FC) in the side scatter vs CD38 histogram mode, and the CD38-gated plasma cell population was identified. The positive cell ratios of kappa and lambda to plasma cell populations were analyzed. PCM cells were distinguished from normal plasma cells by a cut-off level between 0.80 and 3.3, a sensitivity of 90.3%, and a specificity of 81.1%. Twocolor FC analysis is simple to perform, inexpensive, and clinically relevant data are obtained soon after completion of the FC measurements. It could be one of the helpful tools in the diagnosis of PCM. The correct diagnosis of PCM can be achieved more simply, efficiently, and rapidly by combining this method.Plasma cell myeloma (PCM) is a bone marrow (BM)-based, multifocal, plasma cell neoplasm associated with an M-protein in serum and/or urine. In most cases, tumor cells disseminated to the BM are involved. To diagnose PCM, criteria from the World Health Organization (WHO) are usually employed (1). They are based on a combination ofpathological, radiological, and clinical features. However, the diagnostic criteria are complex and several laboratory parameters are required for an appropriate diagnosis. The diagnosis involves evaluation of the clinical burden of plasma cell infiltration, analyses of radiologically detectable bone lesions, electrophoretic determination of monoclonal immunoglobulins (Ig), and assessment of plasma cells in the BM. Through retrospective analyses, we investigated the diagnostic value of an abnormal cytoplasmic kappa/lambda ratio of CD38-gated plasma cells assessed by flow cytometry (FC). We found the diagnostic range for the kappa/lambda ratio, which would allow to maximize the sensitivity and specificity of diagnosis, and to minimize false-positive and false-negative results.

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Bone-marrow plasmocytosis ? An immunohistological study

Cited by 17 publications

References 17 publications

An approach for diagnosing plasma cell myeloma by three-color flow cytometry based on kappa/lambda ratios of CD38-gated CD138+ cells

An approach for diagnosing plasma cell myeloma by three-color flow cytometry based on kappa/lambda ratios of CD38-gated CD138+ cells

Bone marrow immunohistology of plasma cell neoplasms

An Approach for Plasma Cell Myeloma Diagnosis by Two-Color Flow Cytometry Based on Kappa/Lambda Ratios of CD38-Gated Plasma Cells

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