Low grade marginal zone B-cell lymphoma presenting as local amyloidosis in a submandibular salivary gland

Perera, Esther; Revington, Peter; Sheffield, E.

doi:10.1016/j.ijom.2010.05.001

Cited by 10 publications

(3 citation statements)

References 8 publications

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“…Localized AL amyloidosis with a localized clonal plasma cell population has been described in single case reports and in smaller cohorts [11,12,38,39]. Table 3 provides an overview of the literature with larger case series.…”

Section: Discussionmentioning

confidence: 99%

“…Ig-rearrangement analyses were not done in any of the cases. Single case reports and studies with smaller cohorts present localized AL amyloidosis with an associated light chain restricted plasma cell population at different anatomical sites [12,38,39]. In all these studies, molecular analyses and assessment of the light chain restriction of the plasma cells have been carried out inconsistently or only in few cases, and a precise classification of the concomitant clonal plasma cell population, especially focusing on the differentiation between an extremely plasmacytic-differentiated marginal zone lymphoma and a pure plasma cell neoplasia, is largely missing (Table 3).…”

Section: Discussionmentioning

confidence: 99%

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AL amyloidosis with a localized B cell neoplasia

et al. 2019

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Immunoglobulin light chain-derived (AL) amyloidosis may occur as a systemic disease usually with dismal prognosis and a localized variant with favorable outcome. We report 29 patients with AL amyloidosis and associated lymphoplasmacytic infiltrate spatially related to amyloid deposits. In 17 cases, the amyloid deposits were classified as ALλ and 12 as ALκ Histopathology in all cases showed relatively sparse plasma cells and B cells without tumor or sheet formation by the lymphoplasmacytic infiltrate. The B cells predominantly showed an immunophenotype of the marginal zone. In situ, hybridization revealed 17 cases with λ− and 10 with κ light chain restricted plasma cells, which was concordant with the AL subtype in each case. Clonal immunoglobulin heavy variable gene (IGHV) or κ light chain rearrangement was found in 23/29 interpretable cases. A single case harbored a MYD88 L265P-mutation. Taken together, we detected 27 (93%) cases of AL amyloidosis with an associated light chain restricted and predominantly molecularly clonal plasma cell population. Clinical data were available in 18 patients. Five patients suffered from systemic lymphoma and two from systemic AL amyloidosis. The remaining cases were classified as localized with regard to both, the AL amyloidosis and the light chain restricted plasma cell population. To the best of our knowledge, we herein present the largest cohort of AL amyloidosis associated with a light chain restricted and predominantly molecularly clonal plasma cell population, which we designate as a distinct disease entity: BAL amyloidosis with a localized B cell neoplasia of undetermined significance^.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

AL amyloidosis with a localized B cell neoplasia

et al. 2019

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“…Moreover, amino acid sequence analysis of amyloid light chain proved the monoclonal nature of the protein (either κ or λ ) in those cases examined [4, 5]. If it was abundant, the cellular component in the lesions was also analysed and frequently found to be monoclonal or obviously neoplastic [6–11]. Polyclonal nature of the infiltrating plasma cells was also found in some cases which seemingly contradicts the neoplastic nature of the lesion [8].…”

Section: Introductionmentioning

confidence: 99%

Localized Amyloidosis of the Upper Aerodigestive Tract: Complex Analysis of the Cellular Infiltrate and the Amyloid Mass

Turiák

Kaszás

Katona

et al. 2019

Analytical Cellular Pathology

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Objectives. The aim of this study was to analyse the composition of amyloid mass and the plasmacytic infiltrate of localized amyloidosis of the upper aerodigestive tract. Methods. Biopsy materials were studied by light microscopy, immunohistochemistry (IHC), and mRNA in situ hybridization (mRNA-ISH). The amyloid mass was also analysed with high-performance liquid chromatography mass spectrometry- (HPLC-MS-) based proteomics. Results. Nodular and diffuse forms of amyloid deposition were detected. IHC analysis revealed λ-light chain (LC) in two cases, κ-LC in one case. The remaining two were positive with both. Proteins, well known from other amyloidoses like amyloid A (AA), prealbumin/transthyretin (PA), apolipoprotein A-I (ApoAI), and amyloid P component (APC), and also keratin were found with variable intensities in the cases. HPLC-MS revealed dozens of proteins with both LCs in all the lesions but sometimes with surprisingly small intensities. mRNA-ISH analysis revealed identical λ and κ dominance and only one normal κ/λ cell ratio. Conclusion. Cellular infiltrate and protein components in the amyloid showed congruent results in all but one case. The only exception with normal cell ratio and λ-dominant amyloid could be originated from the different protein-secreting activity of plasma cell clones. HPLC-MS analysis explored both LCs in all the amyloid in variable amount, but other proteins with much higher intensities like keratins, apolipoprotein A-IV (ApoAIV), were also detected. Proteins like AA, PA, ApoAI, and APC, previously known about amyloid-forming capability, also appeared. This indicates that localized amyloid in the upper aerodigestive tract is not a homogenous immunoglobulin mass but a mixture of proteins. The sometimes very low light chain intensities might also suggest that not all the localized amyloidosis cases of the upper aerodigestive tract are of convincingly AL type, and the analysis of the cellular infiltrate might indicate that not all are monoclonal.

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Miscellaneous Pathologic Processes of the Salivary Glands

2021

Salivary Gland Pathology

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Low grade marginal zone B-cell lymphoma presenting as local amyloidosis in a submandibular salivary gland

Cited by 10 publications

References 8 publications

AL amyloidosis with a localized B cell neoplasia

AL amyloidosis with a localized B cell neoplasia

Localized Amyloidosis of the Upper Aerodigestive Tract: Complex Analysis of the Cellular Infiltrate and the Amyloid Mass

Miscellaneous Pathologic Processes of the Salivary Glands

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