plasma cell leukemia with t 11 14 q13 q32 simulating lymphoplasmacytic lymphoma a diagnostic challenge solved by flow cytometry

Bone marrow biopsy C replaced by medium-sized lymphocytes C1; Hematoxylin andeosinstain, 400 × and immunohistochemistry expression of Ki67 of tumor cells C2; immunoperoxidase, 400×.. Neo

revbrashematolhemoter.2016;x x x(x x):xxx–xxx

w w w r b h h o r g

Brazilian Journal of Hematology and Hemotherapy

Case report

Q1

aUniversidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil

bFundac¸ão Amaral Carvalho, Jau, SP, Brazil

a r t i c l e i n f o

Article history:

Introduction

∗ Corresponding author at:DisciplinadeHematologiaeHemoterapia,EscolaPaulistadeMedicina(EPM),UniversidadeFederaldeSão

Case report

http://dx.doi.org/10.1016/j.bjhh.2016.10.001

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Figure 1 – Neoplastic cell morphology in peripheral blood (A) and bone marrow aspirate films (B) showing small- to

medium-sized lymphoplasmacytic lymphocytes (May Grunwald Giemsa stain, 1000 ×) Bone marrow biopsy (C) replaced by medium-sized lymphocytes (C1; Hematoxylin andeosinstain, 400 ×) and immunohistochemistry expression of Ki67 of tumor cells (C2; immunoperoxidase, 400×).

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CD38 APC

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Figure 2 – Flow cytometry dot plots of the circulating plasma cells (in black dots) showing small- to large-sized clonal plasma cells expressing (forward/side scatter of light) CD45 − , CD19/CD20 − , CD38 ++ /CD138 + heterogeneous and

ckappa + /lambda − Neoplastic cells also expressed CD81 but were negative for CD56, CD28 and CD117 Normal B cells (in dashed lines) are CD45 + , CD19/CD20 + and polyclonal (kappa + and lambda + populations).

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Figure 3 – FISH using probes for theCCND1gene (red) and

IGHgene (green), and red and green fusion, corresponding

toIGH-CCND1rearrangement.

Discussion

MM.1,2,6There isahigh incidenceofanemiaand

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cyclin D1 (CCND1) at 11q13 with the immunoglobulin heavy

chaingeneat14q32and isassociatedwithalonger overall

prognosis

Conflict of interest

r e f e r e n c e s

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