Waldenström's macroglobulinemia differential diagnosis: Difference between revisions

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*[[Multiple myeloma]]:<ref name="UTD">{{cite journal |vauthors=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A, Rodríguez-García JA, Massó P, Pérez-Aliaga A, Monteagudo MD, Navarro I, Moreno G, Toledo C, Alonso A, Besses C, Besalduch J, Jarque I, Salama P, Rivas JA, Navarro B, Bladé J, Miguel JF |title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases |journal=Br. J. Haematol. |volume=115 |issue=3 |pages=575–82 |year=2001 |pmid=11736938 |doi= |url=}}</ref>
*[[Multiple myeloma]]:<ref name="UTD">{{cite journal |vauthors=García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A, Rodríguez-García JA, Massó P, Pérez-Aliaga A, Monteagudo MD, Navarro I, Moreno G, Toledo C, Alonso A, Besses C, Besalduch J, Jarque I, Salama P, Rivas JA, Navarro B, Bladé J, Miguel JF |title=Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases |journal=Br. J. Haematol. |volume=115 |issue=3 |pages=575–82 |year=2001 |pmid=11736938 |doi= |url=}}</ref>
:*Express CD138, CD38, CD79a, VS38c and CD56(70%)
:*Express CD138, CD38, CD79a, VS38c and CD56(70%)
:*Presence of Plasmacytic cell infiltration of bone marrow, osteolytic lesions and [[renal insufficiency]]
:*Presence of plasmacytic cell infiltration of bone marrow, osteolytic lesions and [[renal insufficiency]]
:*Translocation involving chromosome 11 (t11;14)  
:*Translocation involving chromosome 11 (t11;14)  



Revision as of 06:52, 5 January 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mirdula Sharma, MBBS [2]

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Overview

Waldenström's macroglobulinemia must be differentiated from multiple myeloma, chronic lymphocytic leukemia/small lymphocytic lymphoma, b-cell prolymphocytic leukemia, follicular lymphoma, mantle cell lymphoma, and marginal zone lymphoma.[1][2]

Differentiating Waldenström's Macroglobulinemia from other B Cell Lymphoid Neoplasms

Waldenström's macroglobulinemia must be differentiated from other B cell lymphoid neoplasms including:

  • Always express CD5, usually CD23 positive
  • Express bright surface IgM, CD20 and other B-cell antigens (CD19, CD22, CD79a, FMC7)[4][5]
  • Express CD10, HLA-DR, pan B-cell antigens (CD19, CD20, CD79a), CD21, and surface IgM, IgG, or IgA[6][7]
  • Rearrangement of Bcl-2
  • Express CD138, CD38, CD79a, VS38c and CD56(70%)
  • Presence of plasmacytic cell infiltration of bone marrow, osteolytic lesions and renal insufficiency
  • Translocation involving chromosome 11 (t11;14)
  • Express CD5+ and CD23-; surface IgM, IgD and cyclin D1 in majority of cases[8][9]
  • Infiltration of bone marrow by monomorphous, small lymphoid cells with irregular nuclei
  • Marginal zone lymphoma:
  • Expresses B cell markers CD19, CD20, and CD22[10][11]
  • Infiltrates the bone marrow with a characteristic intertrabecular and intrasinusoidal pattern
  • Most common cytogenetic abnormalities are loss of 7q (19%) along with +3q (19%) and +5q (10% )

References

  1. 1.0 1.1 Pangalis GA, Kyrtsonis MC, Kontopidou FN, Vassilakopoulos TP, Siakantaris MP, Dimopoulou MN, Kittas C, Angelopoulou MK (2003). "Differential diagnosis of Waldenstrom's macroglobulinemia from other low-grade B-cell lymphoproliferative disorders". Semin. Oncol. 30 (2): 201–5. doi:10.1053/sonc.2003.50046. PMID 12720136.
  2. Sahin I, Leblebjian H, Treon SP, Ghobrial IM (2014). "Waldenström macroglobulinemia: from biology to treatment". Expert Rev Hematol. 7 (1): 157–68. doi:10.1586/17474086.2014.871494. PMID 24405328.
  3. Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, Döhner H, Hillmen P, Keating MJ, Montserrat E, Rai KR, Kipps TJ (2008). "Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 guidelines". Blood. 111 (12): 5446–56. doi:10.1182/blood-2007-06-093906. PMC 2972576. PMID 18216293.
  4. Del Giudice I, Davis Z, Matutes E, Osuji N, Parry-Jones N, Morilla A, Brito-Babapulle V, Oscier D, Catovsky D (2006). "IgVH genes mutation and usage, ZAP-70 and CD38 expression provide new insights on B-cell prolymphocytic leukemia (B-PLL)". Leukemia. 20 (7): 1231–7. doi:10.1038/sj.leu.2404238. PMID 16642047.
  5. Ravandi F, O'Brien S (2005). "Chronic lymphoid leukemias other than chronic lymphocytic leukemia: diagnosis and treatment". Mayo Clin. Proc. 80 (12): 1660–74. doi:10.4065/80.12.1660. PMID 16342661.
  6. Karube K, Guo Y, Suzumiya J, Sugita Y, Nomura Y, Yamamoto K, Shimizu K, Yoshida S, Komatani H, Takeshita M, Kikuchi M, Nakamura N, Takasu O, Arakawa F, Tagawa H, Seto M, Ohshima K (2007). "CD10-MUM1+ follicular lymphoma lacks BCL2 gene translocation and shows characteristic biologic and clinical features". Blood. 109 (7): 3076–9. doi:10.1182/blood-2006-09-045989. PMID 17138820.
  7. Anderson KC, Bates MP, Slaughenhoupt BL, Pinkus GS, Schlossman SF, Nadler LM (1984). "Expression of human B cell-associated antigens on leukemias and lymphomas: a model of human B cell differentiation". Blood. 63 (6): 1424–33. PMID 6609729.
    • Bone marrow infiltration of small, cleaved cells that are usually paratrabecular
  8. Dorfman DM, Pinkus GS (1994). "Distinction between small lymphocytic and mantle cell lymphoma by immunoreactivity for CD23". Mod. Pathol. 7 (3): 326–31. PMID 8058704.
  9. DiRaimondo F, Albitar M, Huh Y, O'Brien S, Montillo M, Tedeschi A, Kantarjian H, Lerner S, Giustolisi R, Keating M (2002). "The clinical and diagnostic relevance of CD23 expression in the chronic lymphoproliferative disease". Cancer. 94 (6): 1721–30. PMID 11920534.
  10. Harris NL, Jaffe ES, Stein H, Banks PM, Chan JK, Cleary ML, Delsol G, De Wolf-Peeters C, Falini B, Gatter KC (1994). "A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group". Blood. 84 (5): 1361–92. PMID 8068936.
  11. Harris NL, Jaffe ES, Diebold J, Flandrin G, Muller-Hermelink HK, Vardiman J, Lister TA, Bloomfield CD (1999). "World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee meeting-Airlie House, Virginia, November 1997". J. Clin. Oncol. 17 (12): 3835–49. PMID 10577857.

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