A case of lymphoplasmacytic lymphoma mimicking as chronic lymphocytic leukemia
DOI:
https://doi.org/10.18203/2320-6012.ijrms20232842Keywords:
Lymphoma, Lymphoplasmacytic, B-NHL, Small B cell, FCMAbstract
Lymphoplasmacytic lymphoma (LPL) is a B-cell non-Hodgkins lymphoma (B-NHL) that has small lymphocytes, plasmacytoid lymphocytes and plasma cells in varying proportions. It commonly involves the bone marrow, lymph nodes, spleen and rarely other extra-medullary sites. LPL tends to have a varied morphology and immunophenotype (IPT). Though it is characterized by the presence of monoclonal IgM protein in serum, it can also be seen in other B-NHL. Thus, it may impose a diagnostic challenge by morphology and IPT in some cases. Chronic lymphocytic leukaemia (CLL) is another small B cell NHL, which has a more typical morphology and characteristic IPT. IPT is done by flow cytometry (FCM), which is a rapid and efficient tool in the diagnosis of NHL involving blood and marrow. We present a case of LPL which mimicked CLL by morphology and IPT.
References
Morice WG, Chen D, Kurtin PJ, Hanson CA, McPhail ED. Novel immunophenotypic features of marrow lymphoplasmacytic lymphoma and correlation with Waldenström's macroglobulinemia. Modern Pathol. 2009;22(6):807-16.
Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20):2375-90.
Howard MT, Hodnefield J, Morice WG. Immunohistochemical phenotyping of plasma cells in lymphoplasmacytic lymphoma/Waldenström's macroglobulinemia is comparable to flow cytometric techniques. Clin Lymphoma Myeloma Leukemia. 2011;11(1):96-8.
Bazinet A, Rys RN, Wever CM, Barry A, Greenwood C, Young C et al. A 10-color flow cytometry panel for both diagnosis and minimal residual disease measurement in chronic lymphocytic leukemia. Blood. 2019;134:5451.
Growková K, Kryukova E, Kufová Z, Filipová J, Ševčíková T, Říhová L et al. Waldenström′ s macroglobulinemia: Two malignant clones in a monoclonal disease? Molecular background and clinical reflection. Eur J Haematol. 2017;99(6):469-78.
San Miguel JF, Vidriales MB, Ocio E, Mateo G, Sanchez-Guijo F, Sanchez ML et al. Immunophenotypic analysis of Waldenstrom's macroglobulinemia. InSeminars Oncol. 2003;30(2):187-95.
Matutes E, Owusu-Ankomah K, Morilla R, Houlihan A, Que TH, Catovsky D. The immunological profile of B-cell disorders and proposal of a scoring system for the diagnosis of CLL. Leukemia. 1994;8(10):1640-5.
Moreau EJ, Matutes E, A’Hern RP, Morilla AM, Morilla RM, Owusu-Ankomah KA et al. Improvement of the chronic lymphocytic leukemia scoring system with the monoclonal antibody SN8 (CD79b). Am J Clin Pathol. 1997;108(4):378-82.
Hoffmann J, Rother M, Kaiser U, Thrun MC, Wilhelm C, Gruen A et al. Determination of CD43 and CD200 surface expression improves accuracy of B‐cell lymphoma immunophenotyping. Cytometry Part B: Clin Cytometry. 2020;98(6):476-82.
Ramalingam TR, Mohanraj S, Muthu A, Prabhakar V, Ramakrishnan B, Vaidhyanathan L et al. Independent diagnostic utility of CD20, CD200, CD43 and CD45 in chronic lymphocytic leukaemia. Leukemia Lymphoma. 2022;63(2):377-84.
Konoplev S, Medeiros LJ, Bueso-Ramos CE, Jorgensen JL, Lin P. Immunophenotypic profile of lymphoplasmacytic lymphoma/ Waldenström macroglobulinemia. Am J Clin Pathol. 2005;124(3):414-20.
