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Primary cutaneous plasmacytoma: a role for a triggering stimulus?

Primary cutaneous plasmacytoma is a rare type of cutaneous B-cell lymphoma, characterized by clonal proliferation of plasma cells, that primarily develops in the skin. Five cases have been described to date in which a local triggering stimulus may be involved in development of this skin tumour. We describe the case of a primary cutaneous plasmacytoma localized to the lower lip. This site had been affected for 15 years with recurrent herpes simplex virus-1 infection. Neoplastic plasma cells were found to be bcl-2-positive. We hypothesize that chronic stimulation of keratinocytes by herpes simplex virus-1, possibly through toll-like receptors, may have favoured the release of cytokines (e.g. interleukin-6) able to induce plasma cell proliferation, transformation and survival.

Aged↗

Plasmacytoma and follicular lymphoma in a case of Hashimoto's thyroiditis.

Monoclonal gammopathy (IgG, lambda) in a 37-year-old man with Hashimoto's thyroiditis, was markedly decreased after thyroidectomy. Histological examination of the thyroid showed large lymphoid follicles surrounded by a massive proliferation of plasma cells. Immunological studies revealed that interfollicular plasma cells stained monotypically for lambda chain, findings in keeping with a diagnosis of plasmacytoma of the thyroid. In addition, there was kappa monotypic staining of the lymphoid follicles and absence of tangible body macrophages, indicating the presence of a follicular lymphoma derived from a separate cell line from the plasmacytoma.

Adult↗

Clinicopathologic study of cutaneous plasmacytoma.

Eight patients with skin tumor lesions composed of dense, predominantly plasma cell infiltrates were studied. Primary cutaneous plasmacytoma can be reactive (polyclonal) or neoplastic (monoclonal). In four of the patients skin lesions were associated with multiple myeloma. Specific skin lesions usually consisted of reddish or purple nodules located on the trunk. In one case the cutaneous lesions developed at the site of previous herpes zoster. Histologically, the cutaneous plasmacytic infiltrate was mainly diffuse and monomorphous. Most of the plasma cells were mature, but in some cases immature immunoblasts and mitoses were observed. Serum immunoelectrophoresis findings correlated with the monoclonality or polyclonality of the plasmacytoma. Presence or absence of systemic involvement cannot be predicted from the appearance of clinical lesions or from maturity of plasma cell infiltration in the skin.

Aged↗

Histone H1 kinase from mouse plasmacytoma. Further characterization and molecular structure.

A cAMP-independent protein kinase which phosphorylates histone H1 to a high level and which may correspond to the mitotic H1 kinase has been partially purified and characterized from mouse plasmacytoma microsomes [Quirin-Stricker, C., and Schmitt, M. (1981) Eur. J. Biochem. 118, 165-172]. The present study compares the microsome-associated and the chromatin-associated histone H1 kinases isolated from mouse plasmacytoma cells. The results indicate that the two H1 kinases are indistinguishable by several criteria. The molecular structure of the microsome-associated histone H1 kinase has been determined (a) by exclusion chromatography on Ultrogel, (b) by electrophoresis in non-denaturing polyacrylamide gels of graded porosity and (c) by sodium dodecyl sulfate/polyacrylamide gel electrophoresis of the H1 kinase activity peak from an AcA-34 Ultrogel column. All these techniques gave the same result: H1 kinase may exist in a native form as a monomeric enzyme with an apparent relative molecular mass of 90 000 +/- 8000.

Animals↗

Extramedullary plasmacytoma of the gastrointestinal tract in a renal transplant recipient.

A case of gastrointestional plasmacytoma found in a renal transplant recipient is described. Immunohistochemical study using immunoglobulin-enzyme bridge technique demonstrated IgA and k-type light chains in the majority of plasma cells infiltrated in the stomach. Pathological investigation revealed multiple similar tumors in the ileum, cecum and ascending colon suggesting a plasmacytoma of multicentric gastrointestinal origin. The pathogenesis of plasma cell tumors is briefly discussed with regard to organ transplantation.

Adult↗

IgG-kappa-producing primary plasmacytoma of the thyroid gland with preoperative serum M protein.

A case of primary plasmacytoma of the thyroid gland which occurred in a 63-year-old woman is reported. Histologic and ultramicroscopic examination revealed that the excised thyroid tumor was plasmacytoma superimposed on lymphocytic thyroiditis. Immunohistological study showed that the tumor cells produced intracytoplasmic immunoglobulin (IgG-kappa). Electrophoretic and immunoelectrophoretic studies disclosed the presence of monoclonal immunoglobulin (IgG-kappa) in samples of the patient's serum which had been obtained preoperatively. After completion of irradiation therapy to the neck following tumor removal, the serum monoclonal immunoglobulin disappeared. The patient is currently alive and well without any evidence of the tumor three years after surgery.

Blood Proteins↗

Cyberknife radiosurgery for basal skull plasmacytoma.

The Cyberknife delivers frameless image-guided stereotactic radiosurgery to intracranial and extracranial tumors. We report our use of Cyberknife radiosurgery on a medullary plasmacytoma in the clivus extending into the foramen magnum. No acute toxicity was seen during or within 24 hours of treatment, and the subject had a complete and durable radiographic response on MRI 12+ months after treatment. To our knowledge, this is a first case of successful Cyberknife radiosurgery of a medullary plasmacytoma.

Humans↗

Extramedullary plasmacytoma of stomach.

A single case of gastric plasmacytoma showing unusual clinical and pathological features is described. The patient had gluten sensitive enteropathy, and showed increased circulating IgA levels prior to gastrectomy. Progression of the disease was associated with both K and L light chain proteinuria, hypoalbuminaemia, and vasopressin resistant polyuria. Pathological investigation revealed the coexistence of IgA secreting soft tissue plasmacytoma, with IgG secreting myeloma. The significance of these findings is discussed.

Autopsy↗

Acute plasma cell leukaemia followed by extramedullary plasmacytoma.

A 54-year-old male was hospitalized because of lethargy, weight loss, an upper abdominal mass, hepatosplenomegaly and peripheral blood plasmacytosis of 66%. The diagnosis of acute plasma cell leukaemia was established, and after chemotherapy was initiated, the patient entered complete remission. 6 months later, he developed extramedullary plasmacytoma with involvement of the gastrointestinal tract, right inguinal lymph nodes and right orbit. Response to chemotherapy was poor and he died without evidence of plasma cell leukaemia. The possibility of the existence of extramedullary plasmacytoma at the onset of the disease, expressed by the appearance of plasma cell leukaemia only at the beginning and by extramedullary spreading at the terminal stage is discussed.

Antineoplastic Agents↗

Extramedullary plasmacytomas and solitary plasma cell tumours of bone.

We describe clinical features and treatment results in 25 patients with solitary osseous (SOP) and 18 patients with solitary extramedullary plasmacytoma (EMP). 41 patients were treated with high-voltage radiotherapy, median 40 Gy in 20 fractions. Surgery was part of the treatment in 21 and chemotherapy in 5 patients. The median age in both groups was 56 years, with a preponderance of males. Myelomatosis developed in 10 SOP and 2 EMP patients, and this development did not correlate with the presence or absence of an M-component at the time of diagnosis of plasmacytoma. The estimated 5- and 10-y survival was 87% and 76% without a statistical difference between SOP and EMP groups. The patients in the SOP group usually died from myelomatosis while EMP patients died from other causes.

Bence Jones Protein↗

Plasmacytoma of anterior maxilla mimicking periapical cyst.

An unusual case of plasmacytoma mimicking a large periapical cyst in the anterior maxilla is described. Of the involved teeth, 22 was discoloured and had an open, immature apex, a feature strongly suggestive of the lesion being of pulpal origin. The case was treated by a conservative endodontic approach, but failed to show any improvement. Apical surgery comprising complete enucleation of the cystic lesion and extraction of the involved tooth was carried out. The unexpected histopathological finding was a plasmacytoma.

Adult↗

Solitary dural plasmacytoma.

Only four of the nine published cases of solitary, extraskeletal, intracranial plasmacytoma are considered authentic. In this report we describe an accidentally discovered dural plasmacytoma and draw the attention to this rare lesion which might have a different prognosis from the rather benign course of meningioma with which it is confused.

Brain↗

Ascorbic acid: a culture requirement for colony formation by mouse plasmacytoma cells.

Plasmacytoma stem cells explanted from mice formed colonies in culture only in the presence of L-ascorbic acid; this vitamin was not needed for the formation of granulocytic colonies. Isomers of L-ascorbic acid with less antiscorbutic activity also promoted plasmacytoma colony formation, but less effectively. Other redox compounds without antiscorbutic activity and an antioxidant were ineffective.

Animals↗

Mouse c-myc oncogene is located on chromosome 15 and translocated to chromosome 12 in plasmacytomas.

Hybridization studies with viral oncogene probes indicate that c-myc, the cellular gene homologous to the transforming gene of avian myelocytomatosis virus, resides on mouse chromosome 15 and in many plasmacytomas is translocated to the antibody heavy chain gene locus on chromosome 12. The transcriptional orientation of the translocated c-myc sequence is opposite the orientation of the adjacent C alpha gene that codes for the heavy chain of immunoglobulin A. The translocated c-myc sequence is not the same oncogene detected in urine plasmacytomas by the NIH-3T3 cell transformation assay.

Animals↗

Amplification of a specific set of intracisternal A-particle genes in a mouse plasmacytoma.

Intracisternal A-particles (IAPs) derive from endogenous retrovirus-like genes that are present in ca. 1,000 copies per haploid mouse genome. A particular IAP sequence variant that represents only 2% of the endogenous genes was found to be the predominant transcript in five out of seven plasmacytoma lines examined, and these genes have been amplified two- to fourfold in MOPC 315. Restriction enzyme digests of normal and tumor DNAs revealed a set of conserved sites within the population of amplified genes which could be used to generate a consensus restriction enzyme map of the amplified IAP genome. Molecular clones of IAP genes related to those amplified in MOPC 315 were isolated from gene libraries of MOPC 315 and MOPC 104E DNAs. Each clone was characterized for the presence of the restriction enzyme sites conserved in the amplified genes. Of 26 clones isolated from MOPC 315 DNA, 14 contained all of the conserved sites, whereas none of the clones isolated from MOPC 104E DNA contained all of the sites. These results suggested that approximately one-half of the genes isolated from MOPC 315 DNA were members of the amplified IAP gene population, representing newly acquired proviruses in the tumor DNA. Unique cellular flanking sequences were isolated from four of the MOPC 315 clones and four of the MOPC 104E clones. Probes from three of the MOPC 315 clones detected restriction fragments that were unique to MOPC 315 DNA and equivalent in size to the cloned gene, demonstrating that these three IAP genes had integrated into new sites in the plasmacytoma DNA. The other five clones were found to be endogenous to the BALB/c genome. Thus, IAPs represent a significant source of insertional mutations for any cell expressing the retrovirus-like particles. Furthermore, these results suggest that only one or a small number of endogenous IAP sequences are activated to give the homogeneous population of amplified genes.

Animals↗

DNA repair in the c-myc proto-oncogene locus: possible involvement in susceptibility or resistance to plasmacytoma induction in BALB/c mice.

This report describes an unexpected difference in the efficiency of removal of UV-induced DNA damage in the c-myc locus in splenic B lymphoblasts from two inbred strains of mice. In cells from plasmacytoma-resistant DBA/2N mice, 35% of UV-induced damage in the regulatory and 5' flank of c-myc is removed by 12 h. However, in cells from plasmacytoma-susceptible BALB/cAn mice, damage is not removed from this region. In the protein-encoding region and 3' flank of c-myc as well as in two dihydrofolate reductase gene fragments, UV damage is repaired with similar efficiency in B lymphoblasts from both strains of mice. Furthermore, in the protein-encoding portion and 3' flank of c-myc, damage is selectively removed from only the transcribed strand. No repair is detected in the nontranscribed strand. In contrast, DNA repair in the 5' flank of c-myc is not strand specific; in DNA from DBA/2N cells, UV damage is rapidly removed from both the transcribed and nontranscribed strands. In BALB/cAn cells no repair was detected in either strand in the 5'flank, consistent with the results with double-stranded, nick-translated probes to this region of c-myc. In addition to the repair studies, we have detected post-UV-damage formation: in most of the genes studied, we find that additional T4 endonuclease-sensitive sites are formed in the DNA 2 h after irradiation. Our findings provide new insights into the details of gene-specific and strand-specific DNA repair and suggest that there may be close links between DNA repair and B-cell neoplastic development.

Animals↗

Addition of constitutive c-myc expression to Abelson murine leukemia virus changes the phenotype of the cells transformed by the virus from pre-B-cell lymphomas to plasmacytomas.

Abelson murine leukemia virus (A-MuLV), a retrovirus that expresses the v-abl oncogene, characteristically induces pre-B-cell lymphomas following in vivo infection of BALB/c mice or in vitro infection of suspensions of fetal liver or bone marrow cells. ABL-MYC, a retrovirus that expresses both v-abl and c-myc, induces solely plasmacytomas in BALB/c mice. To investigate how the addition of overexpression of c-myc to that of v-abl accomplishes this dramatic change in the phenotype of the cells transformed by these closely related retroviruses, we utilized helper-free A-MuLV (psi 2) and ABL-MYC (psi 2) in vitro to infect suspensions of cells from different lymphoid tissues and purified immature and purified mature B cells. As expected, A-MuLV(psi 2) induced only pre-B-cell lymphomas in vivo and in vitro when immature B cells were present. ABL-MYC(psi 2), on the other hand, produced only plasmacytomas, even when purified immature B lymphocytes were infected in vitro. Although the A-MuLV(psi 2)-induced pre-B-cell lymphomas express easily detectable levels of c-myc mRNA, maturation into more-mature forms of B lymphocytes is blocked. The constitutively overexpressed c-myc in the ABL-MYC retrovirus abrogates this block, permits maturation of infected immature B cells, and yields transformed plasma cells.

Abelson murine leukemia virus↗

Efficiency alleles of the Pctr1 modifier locus for plasmacytoma susceptibility.

The susceptibility of BALB/c mice to pristane-induced plasmacytomas is a complex genetic trait involving multiple loci, while DBA/2 and C57BL/6 strains are genetically resistant to the plasmacytomagenic effects of pristane. In this model system for human B-cell neoplasia, one of the BALB/c susceptibility and modifier loci, Pctr1, was mapped to a 5.7-centimorgan (cM) chromosomal region that included Cdkn2a, which encodes p16(INK4a) and p19(ARF), and the coding sequences for the BALB/c p16(INK4a) and p19(ARF) alleles were found to be polymorphic with respect to their resistant Pctr1 counterparts in DBA/2 and C57BL/6 mice (45). In the present study, alleles of Pctr1, Cdkn2a, and D4Mit15 from a resistant strain (BALB/cDAG) carrying DBA/2 chromatin were introgressively backcrossed to the susceptible BALB/c strain. The resultant C.DAG-Pctr1 Cdkn2a D4Mit15 congenic was more resistant to plasmacytomagenesis than BALB/c, thus narrowing Pctr1 to a 1.5-cM interval. Concomitantly, resistant C57BL/6 mice, from which both gene products of the Cdkn2a gene have been eliminated, developed pristane-induced plasma cell tumors over a shorter latency period than the traditionally susceptible BALB/cAn strain. Biological assays of the p16(INK4a) and p19(ARF) alleles from BALB/c and DBA/2 indicated that the BALB/c p16(INK4a) allele was less active than its DBA/2 counterpart in inducing growth arrest of mouse plasmacytoma cell lines and preventing ras-induced transformation of NIH 3T3 cells, while the two p19(ARF) alleles displayed similar potencies in both assays. We propose that the BALB/c susceptibility/modifier locus, Pctr1, is an "efficiency" allele of the p16(INK4a) gene.

3T3 Cells↗