Aberrant acquisition of T-cell associated markers in plasma cell neoplasms: An aggressive disease with extramedullary involvement and very short survival Aberrant T markers on malignant plasma cells
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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.
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References
2. Lau LG, Tan LK, Koay ES, Ee MH, Tan SH, Liu TC. Acute lymphoblastic leukemia with the phenotype of a putative B-cell/T-cell bipotential precursor. Am J Hematol. 2004;77(2):156–60.
3. Suzuki Y, Yoshida T, Wang G, Aoki T, Katayama T, Miyamoto S, et al. Incidence and clinical significance of aberrant T-cell marker expression on diffuse large B-cell lymphoma cells. Acta Haematol 2013;130(4):230-7
4. Tsuyama N, Ennishi D, Yokoyama M, Baba S, Asaka R, Mishima Y, et al. Clinical and
prognostic significance of aberrant T-cell marker expression in 225 cases of de novo diffuse large B-cell lymphoma and 276 cases of other B-cell lymphomas. Oncotarget 2017;8(20):33487-500
5. Samah Kohla, Feryal A. Ibrahima; Deena Mudawi; Susanna Akiki, Dina Soliman, et al. High-Grade Epstein-Barr Virus-Negative Biphenotypic Lymphoma with Expression of B- and T-Cell Markers and Leukemia Presentation: Case Report and Literature Review. Case Rep Oncol 2020;13:1215–1226
6. Pan Z, Hu S, Li M, Zhou Y, Kim YS, Reddy V, et al. ALK-positive Large B-cell Lymphoma: A Clinicopathologic Study of 26 Cases With Review of Additional 108 Cases in the Literature. Am J Surg Pathol 2017;41(1):25-38
7. Spier CM, Grogan TM, Durie BG, et al. T-cell antigen-positive multiple myeloma. Mod Pathol 1990; 3: 302-7.
8. Hao M, Barlogie B, Tricot G, Liu L, Qiu L, et al. Gene Expression Profiling Reveals Aberrant T-cell Marker Expression on Tumor Cells of Waldenström’s Macroglobulinemia. Clin Cancer Res; 25(1) January 1, 2019.
9. Petitjean B, Jardin F, Joly B, et al. Pyothorax-associated lymphoma: a peculiar clinicopathologic entity derived from B cells at late stage of differentiation and with occasional aberrant dual B- and T-cell phenotype. Am J Surg Pathol. 2002;26:724–732.
10. Yagci M, Sucak GT, Akyol G, Haznedar R. Hepatic failure due to CD3+ plasma cell infiltration of the liver in multiple myeloma. Acta Haematol 2002; 107: 38-42
11. Gorczyca W. Atlas of differential diagnosis in neoplastic hematopathology. 3rd ed. Boca Raton: CRC Press, 2014; 359-81.
12. Bladé J, Lust JA, Kyle RA. Immunoglobulin D multiple myeloma: presenting features, response to therapy, and survival in a series of 53 cases. J Clin Oncol. 1994;12:2398-404
13. Usmani SZ, Heuck C, Mitchell A, et al. Extramedullary disease portends poor prognosis in multiple myeloma and is over-represented in high-risk disease even in the era of novel agents. Haematologica. 2012;97:1761-7.
14. Hao Y, Khaykin D, Machado L, et al: Bone marrow morphologic feature, MyPRS and gene mutation correlations in plasma cell myeloma. Mod Pathol, 2019
15. Elsabah H, Soliman DS, Ibrahim F. et al.: Plasma Cell Myeloma with an Aggressive Clinical Course and Anaplastic Morphology in a 22-Year-Old Patient: A Case Report and Review of Literature. Am J Case Rep, 2020; 21: e920489
16. Akihito F, Yasuhiro N, Naofumi Y, Yuji K: Morphological transformation of myeloma cells into multilobated plasma cell nuclei within 7 Days in a case of secondary plasma cell leukemia that finally transformed as anaplastic myeloma. Case Rep Hematol, 2017; 2017: 5758368
17. Jai-Hyang Go. Aberrant CD3 Expression in a Relapsed Plasma Cell Neoplasm. Journal of Pathology and Translational Medicine 2018; 52: 202-205
18. Marković O, Marisavljević D, Cemerikić V et al: Proliferative activity of myeloma cells determined by Ki-67 antibody: Biological and clinical significance. Vojnosanit Pregl, 2005; 62(1): 33–38
19. Juskevicius R, Murthy H, Dangott B: Plasma cell myeloma with very high Ki67 proliferation rate: comparison of visual estimation and computational image analysis with description of clinical and pathologic features. Am J Clin Pathol, 2015; 144(2): A132
20. Jennifer L. Oliveira, Karen L. Grogg, William R. Macon, et al. Clinicopathologic Features of B-Cell Lineage Neoplasms with aberrant expression of CD3. A Study of 21 Cases
21. Mishra P, Kakri S, Gujral S. Plasmablastic transformation of plasma cell myeloma with heterotropic expression of CD3 and CD4: a case report. Acta Clin Belg 2017;72(4):250-3
22. Gabriel K. Habermehl, Jason D. Chesser, Karl S. Theil, Heesun J. Rogers. Very unusual expression of multiple aberrant T‐cell markers in plasmablastic plasma cell myeloma. Int J Lab Hematol. 2019;41:e89–e91.
23. Smita P. & Bachir A. Aberrant T-cell antigen expression in a plasma cell neoplasm. Blood works. Images in hematology ASH image Bank DOI 10.1182/blood-2018-04-843730
24. Sorigue M, Junc_a J, Gassiot S, Mill_a F, Mate J-L, and Navarro JT. A Case of CD138-/CD19+/CD4+ IgD Plasma Cell Leukemia. Cytometry Part B 2015; 88B: 69–73.
25. Tang YL, Chau CY, Yap WM, Chuah KL. CD3 expression in plasma cell neoplasm (multiple myeloma): a diagnostic pitfall. Pathology 2012; 44: 668-70.
26. Luo X, Kuklani R, Bains A. Dual CD3 and CD4 positive plasma cell neoplasm with indistinct morphology: a diagnostic pitfall. Pathology 2016; 48: 378-80.
27. Varricchio S, Pagliuca F, Travaglino A, Gallo L, Villa MR, Mascolo M. Cutaneous localization of plasmablastic multiple myeloma with heterotopic expression of CD3 and CD4: Skin involvement revealing systemic disease. J Cutan Pathol. 2019;46:619–622.
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