acid-phosphatase and Leukemia--Plasma-Cell

Plasmacytic morphologic characteristics are usually associated with cells of B-lymphocyte origin. Recently, plasmacytoid T-cells have been described in reactive lymph nodes and a rare form of lymphoma characteristically associated with myeloproliferative disorders. This report documents a case of plasmacytoid T-cell malignancy that initially presented as an acute leukemia in an elderly man with a longstanding myelodysplastic syndrome. The tumor replaced bone marrow and involved lymph nodes. Despite aggressive therapy, he died quickly of his leukemia/lymphoma. This case illustrates the need for complete cellular analysis in the diagnosis of morphologically plasmacytic malignancies and raises additional questions about the relationship of this peculiar type of T-cell to the hematopoietic marrow.

Topics: Acid Phosphatase; Aged; Antibodies, Monoclonal; Antigens, CD; Cell Cycle; Diagnosis, Differential; DNA, Neoplasm; Fluorescent Antibody Technique; Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; Histocytochemistry; Humans; Karyotyping; Leukemia, Lymphocytic, Chronic, B-Cell; Leukemia, Plasma Cell; Male; Microscopy, Electron; Myelodysplastic Syndromes; T-Lymphocytes

A detailed classification of plasma cells stained for acid phosphatase activity is introduced. With this method, patients with multiple myeloma, non-myeloma gammopathies, reactive plasmacytosis and other diseases in which plasma cells are involved, were investigated. The results show that our method can discriminate between multiple myeloma and reactive plasmacytosis. The overlap between multiple myeloma and other monoclonal gammopathies is much smaller than observed in other studies. Surprisingly low levels of acid phosphatase activity were found in the cells from patients with lymphoplasmacytoid immunocytoma. It is concluded that the acid phosphatase score can be of value for studying disorders in which plasma cells are involved.

Topics: Acid Phosphatase; Histocytochemistry; Humans; Leukemia, Plasma Cell; Lymphoma; Lymphoproliferative Disorders; Multiple Myeloma; Plasma Cells

Topics: Acid Phosphatase; Cyclophosphamide; Cytarabine; Drug Therapy, Combination; Fluorescent Antibody Technique; Glucuronidase; Histocytochemistry; Humans; Immunoelectrophoresis; Immunoglobulin Fragments; Karyotyping; Leukemia, Plasma Cell; Male; Melphalan; Microscopy, Electron; Microscopy, Fluorescence; Middle Aged; Plasma Cells; Prednisone; Prognosis; Remission, Spontaneous; Staining and Labeling; Vincristine