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Ig/myc translocations of the plasmacytoma-prone BALB/c strain occur independently of the genetic and parental origin of the affected chromosomes 6, 12, and 15.

Virtually all murine plasmacytomas (MPCs) carry chromosomal translocations that juxtapose myc on chromosome 15 (chr 15) to one of the three immunoglobulin loci carrying chr 6, 12, or 16. Only some mouse strains are susceptible to MPC induction, however, with BALB/c as the outstanding example. Most other strains are resistant. Our earlier studies with reciprocal BALB/c<-->DBA/2 chimeras suggested that part of this susceptibility is determined at the level of the target cell itself (DBA/2 is MPC resistant). The probability of the Ig/myc translocation is one of the possibly relevant variables. Because MPC resistance is dominant over susceptibility, it is conceivable that the translocations prevail due to some deficiency of the Ig rearrangement or Ig-associated repair mechanisms in BALB/c cells. This could be determined at the level of the chromosomes that participate in the translocation or by genes on other chromosomes. Here, we show that the substitution of the BALB/c-derived chr 12, 6, and 15, which carry IgH, kappa, and myc, respectively, with their homologs derived from MPC-resistant mice, did not affect MPC susceptibility. The use of Robertsonian 4.12 and 6.15 chromosomes in this study has also provided us with the opportunity to assess the parental derivation of the chromosomes participating in the translocation. In contrast to the human chronic myeloid leukemia (CML)-associated BCR/ABL fusion transcript, where a strong bias was claimed that was attributed to imprinting, we have found that the parental chromosomes were randomly involved in the translocation. We have also shown that the translocations could be of uniparental or biparental origin.

Animals↗

Solitary meningeal plasmacytoma: Report of a case with electron microscopic and immunohistologic observations.

An unusual case of solitary extraskeletal plasmacytoma (SEP) arising from the meninges of the anterior fossa in a 58-year-old woman is presented. Despite an apparently complete surgical excision and 5000 rads to the tumor area given postoperatively, a recurrence ensued 5 years later. During the 5 years of clinical observation, repeated serum electrophoresis and immunoelectrophoresis, bone surveys, and bone marrow aspirations have ruled out the presence of underlying multiple myeloma. Immunofluorescence studies of the recurrent tumor showed the neoplastic cells to be producing a monoclonal immunoglobulin (IgA, kappa). Ultrastructural examination showed neoplastic plasma cells with marked nucleocytoplasmic asynchrony, frequent cytoplasmic electron-dense bodies, and rough endoplasmic reticulum dilated and filled with with electron-dense material. A critical evaluation of the eight cases of intracranial SEP published in the literature revealed that only three are well-documented examples of this tumor.

Diagnosis, Differential↗

Solitary secretory plasmacytoma of the lung in a 14-year-old boy.

A case of solitary plasmacytoma of the lung in a 14-year-old boy is reported. The diagnosis was made after a lobectomy was performed for the presence of a mass in the right lung. Two aspects of this case are of particular interest: the young age of the patient and the disappearance after 2 months of the M-protein of of the IgG-k type which was present in the serum.

Adolescent↗

Plasmacytoma of the stomach: diagnosis with the aid of immunoperoxidase technique.

A gastric tumor, originally diagnosed as a plamacytoma in 1953, but in which the diagnosis was disputed, has been re-examined by the immunoperoxidase staining technique. The demonstration of a single type of immunoglobulin in the tumor cells is considered conclusive evidence of its neoplastic nature. Two further cases of gastrict plasmacytoma encountered in recent months have also been examined by this technique and similar results obtained. The pathology of plasma cell tumors is discussed and a brief review of the literature is added with regard to the management and the overall poor prognosis.

Clone Cells↗

Solitary extramedullary plasmacytoma of the upper respiratory and digestive tracts.

The diagnosis, treatment and follow-up data for patients with malignant solitary extramedullary plasmacytoma of the upper respiratory and digestive tracts for the period from 1949 to 1975 are presented. The neoplasm developed in the nasal fossae in 3 patients; in the maxillary sinuses in 2; in the supraglottic region in 1; and in the tonsillar fossa in 1. Curative radiation therapy is recommended after the diagnosis is established by biopsy examination only. In the present series, this practice resulted in complete regression of the tumors in all of the patients, with restoration of functions without local recurrence. In no case did the local disease transform into systemic myeloma.

Adult↗

Extramedullary plasmacytoma with gastric and lymph node involvement: an immunological study.

A case of gastric and lymph node extramedullary plasmacytoma is reported in a young Algerian female. Treatment with cyclophosphamide was ineffective, but rubidazone, followed by a maintenance therapy with prednisone, procarbazine, and vinblastine induced a complete remission. Immunofluorescence studies and biosynthesis experiments in vitro showed that the tumor cells produced and secreted IgA-kappa molecules, whereas no monoclonal immunoglobulin could be found in the serum and gastric juice.

Adult↗

Malignant lymphoma of the thyroid gland with plasma cell differentiation (plasmacytoma).

An unusual case of malignant lymphoma of the thyroid is reported. The predominant appearance of the neoplasm was that of a large cell ("histiocytic") lymphoma, but a discrete portion of the tumor showed features typical of plasmacytoma. Electron microscopy revealed a wide spectrum of cell types, ranging from very immature lymphoid cells to relatively well-developed plasma cells. The findings support the concept that the neoplastic process represents an immunoblastic sarcoma composed of proliferating transformed B lymphocytes (immunoblasts) and their progeny (plasma cells) rather than two distinct lymphoid neoplasms occurring simultaneously.

Aged↗

Gastric plasmacytoma: an immunologic and immunohistochemical study.

A case of IgG (lambda) secreting plasmacytoma arising in the stomach has been presented. Immunohistochemically, the tumor cells contained IgG-lambda immunoglobulin. Immunoelectrophoretic study on patient's serum revealed in the gamma zone the presence of M protein which reacted specifically with anti-IgG and anti-lambda antisera. Agar electrophoresis and immunofixation electrophoresis with anti-IgG and anti-lambda antisera showed multiple subbands. Neuraminidase treatment of the purified IgG from this patient resulted in gradual reduction of four subbands to two. Electrophoretic charge difference of the monoclonal immunoglobulin may be attributed to incompletely synthesized sugar chains attached to the protein core.

Blood Proteins↗

Solitary dural plasmacytoma with conspicuous cytoplasmic inclusions.

A solitary intracranial plasmacytoma originated from the left parietal meninges of a 67-year-old woman; the patient had a four-month history of generalized seizures. Immunoelectrophoresis, performed nine months after surgery, revealed a monoclonal IgG band in the cerebrospinal fluid (CSF) but not in the blood. A peculiar feature of the tumor cells was the presence of abundant hyaline, eosinophilic cytoplasmic inclusions. Ultrastructurally, these inclusions consisted of electron-dense floccular material within distended cisterns of endoplasmic reticulum (ER). These ultrastructural features resemble "thesaurocytes" originally described by Paraskevas et al. in IgA myeloma. Tumors composed mainly of such inclusion-bearing cells are extremely rare. Only a fraction of the tumor cells stained positively for IgG with the immunoperoxidase technique; most inclusion-bearing cells did not stain. It is therefore unlikely that the electron-dense material is stored immunoglobulins.

Cytoplasm↗

Extramedullary plasmacytoma of the small intestine: a case report studied with electron microscopy and immunoperoxidase technique.

A well-documented case of solitary extramedullary plasmacytoma located in the small intestine is presented. The patient underwent local resection of the tumor, and shows no signs of local recurrence or dissemination of the disease after a five-year follow-up. The pathologic nature of plasma cell tumors is discussed, and it is concluded that the demonstration of intracytoplasmatic immunoglobulin is essential for the exact classification of plasma cell neoplasms.

Female↗

Solitary intracranial plasmacytoma.

A case of solitary intracranial plasmacytoma (SIP) spreading from the tentorium toward the right middle and posterior fossae is reported. A particular clinical finding was the presence of an abnormal IgG lambda type in both cerebrospinal fluid (CSF) and serum, which disappeared after partial removal of the tumor followed by radiation therapy. The light and electron microscopical study revealed that the tumor was composed mainly of mature plasma cells. Peculiar deposits of amyloid with a crystalloid plaque-like morphology were scattered throughout tumor tissue; also the tumor vessels showed amyloid infiltrations. The immunohistochemical study confirmed that the tumor was composed of a population of plasma cells producing a single monoclonal immunoglobulin. The findings of this case were compared to those of the few previously reported SIP.

Amyloid↗

Acute renal failure secondary to vascular occlusion by a retroperitoneal plasmacytoma.

A case of acute renal failure secondary to bilateral renal vein occlusion by a retroperitoneal plasmacytoma is described. The use of low-risk radiographic techniques including radionuclide venography and a computerized axial tomography (CAT) scan made a rapid and accurate diagnosis possible. Fatal hemorrhage occurred following tumor erosion and perforation of the vena cava. In patients with multiple myeloma, and clinically apparent retroperitoneal tumor, vascular compromise should be considered in the differential diagnosis of acute renal insufficiency.

Acute Kidney Injury↗

Transformation of chronic lymphocytic leukemia to plasmacytoma.

In a woman with chronic lymphocytic leukemia (CLL), a maxillary plasmacytoma developed after 8 years. The membrane-bound immunoglobulin of the leukemic lymphocytes, the cytoplasmic immunoglobulin of the plasma cells, the serum monoclonal protein and the urine Bence-Jones protein had the same heavy and light chains--mu kappa. This suggests that the leukemic cells transformed to plasma cells. This very rare event is a complete reversal of the more common transformation that occurs in CLL and manifested by de-differentiation. Only in one case out of the 20 previously reported patients with CLL and multiple myeloma there was evidence, like in the current case, of a common clonal origin of the two B-cell neoplasms.

Adult↗

Extramedullary plasmacytoma of the lung.

Three patients with extramedullary plasmacytoma of the lung are described, one of whom also had cervical lymph node metastasis, with the production of an M-protein. The production of M-protein normalized after successful treatment of the localized disease. In all three patients, the disease was locally controlled with radiation therapy, but it became generalized from 6 months to less than 3 years of the initial presentation.

Aged↗

Plasmacytoma of the lung. A case report describing two tumors of different immunologic type in a single patient.

Two pulmonary plasmacytomas of different immunologic type, occurring with an interval of 5 years in the same 65-year-old woman are reported. Both displayed identical light chain types, but different heavy chains. The immunoperoxidase staining technique was used. The patient underwent segmental resection, and no evidence of recurrence or multiple myeloma was found 4 years later. Differential diagnoses are discussed, and the importance of immunologic staining is stressed.

Aged↗

Solitary plasmacytoma of the spine. Long-term clinical course.

The data for 19 patients with solitary plasmacytoma of the spine were reviewed with regard to clinical course and prognosis (median follow-up, 96 months). Eight patients presented with spinal cord compression. A monoclonal immunoglobulin was initially detected in seven of 15 evaluable patients. Treatment included radiotherapy (18 of 19) and/or surgery (11 of 19) and chemotherapy (eight of 19). Spinal cord compression was reversed in every patient. The expected survival rate was 85% at 10 years after diagnosis. Local recurrence or dissemination was observed in 13 patients. It occurred within 5 years of diagnosis in 11 patients and was localized (that is, local recurrence or single bone metastasis) in eight patients. It was always associated with the appearance or an increase of the M component. Dissemination frequently had a "metastatic" pattern with no diffuse bone marrow plasmacytosis. The incidence of local recurrence (five patients) and leukemia (four patients) was high. Local recurrence and/or dissemination were significantly more frequent in patients with the M component at diagnosis than in those without it (P less than 0.05; relative risk, R = 4). The effectiveness of surgery and chemotherapy combined with radiotherapy is also discussed.

Combined Modality Therapy↗