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Rheumatology
Published in Fazal-I-Akbar Danish, Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
In the latter, we find the following: 1 No urinary Bence–Jones’ proteins.2 Plasmacytosis in marrow (<10%).3 Monoclonal protein band in serum/urine electrophoresis, but <3 g/dL.4 No evidence of end-organ damage.
Bone Marrow
Published in Wojciech Gorczyca, Atlas of Differential Diagnosis in Neoplastic Hematopathology, 2014
Increased numbers of plasma cells may be associated with reactive conditions (polyclonal plasmacytosis) and plasma cell neoplasms. The causes of reactive plasmacytosis include inflammatory conditions, chronic infections (mostly viral, but also certain bacterial), autoimmune disorders, hypersensitivity states, HL, anemia (megaloblastic and iron deficiency), cirrhosis, and occasional cases of CML, AML, and metastatic carcinoma. B-cell lymphomas may be accompanied by polyclonal or monoclonal plasmacytosis. Rarely, some T-cell lymphomas (e.g., AITL) may also be associated with often prominent plasmacytosis mimicking plasma cell neoplasms. PCM and monoclonal gammopathy of undetermined significance (MGUS) are defined by the presence of monoclonal plasma cell population. The presence of reactive, perivascular plasmacytosis is often seen in secondary polycythemia and helps in differentiating it from PV. The reactive plasmacytosis, although sometimes very prominent, is usually composed of scattered, nonaggregated plasma cells, which are polytypic by immunohistochemistry (or flow cytometry).
Mechanisms of Fibril Formation and Cellular Response
Published in Martha Skinner, John L. Berk, Lawreen H. Connors, David C. Seldin, XIth International Symposium on Amyloidosis, 2007
Martha Skinner, John L. Berk, Lawreen H. Connors, David C. Seldin
and 4 of TTR in patients 2 and 3 revealed no mutation confirming the diagnosis of senile cardiac amyloidosis. One of these patients had mild plasmacytosis on bone marrow aspirates, but insufficient cells were present to quantify clonality. The third patient with TTR identified by amino acid sequencing (patient 4) had a TTR mutation (Ser50Arg) identified by DNA sequencing of TTR exon 3. This patient had the biopsy during cardiac catheterization required prior to orthotopic liver transplantation.
Angioimmunoblastic T-cell lymphoma with exuberant plasmacytosis and spontaneous tumor lysis syndrome
Published in Baylor University Medical Center Proceedings, 2022
Hafsa Faisal, Syed Ather Hussain, Rachel David, Stephen Silver
Reactive plasmacytosis can be due to infections, autoimmune diseases, serum sickness, or malignancies like AITL.3 The term “exuberant plasmacytosis” has been used to describe severe reactive plasmacytosis, which can very rarely be seen with AITL.3 Exuberant plasmacytosis is defined as more than 20% polyclonal plasma cells in the peripheral blood or >2 × 103/μL absolute plasma cell count.1 The mechanism behind polyclonal plasma cell proliferation in AITL is most likely multifactorial.3 Epstein-Barr virus infection of B cells, resulting in increased production of cytokines like IL-6 and IL-10, has been implicated in reactive plasma cell proliferation.1 The plasmacytosis can initially be concerning for a plasma cell leukemia. However, the establishment of polyclonality with peripheral blood flow cytometry essentially rules out plasma cell malignancy.
Evaluation of sensitivity and specificity of bone marrow trephine biopsy tests in an Indian teaching hospital
Published in Alexandria Journal of Medicine, 2018
Sima Chauhan, Sarita Pradhan, Ripunjaya Mohanty, Abhishek Saini, Kumudini Devi, Mahesh Chandra Sahu
A total 41 cases of lymphoma were analyzed, of which 8 cases were Hodgkin’s lymphoma, and 33 cases were NHL. Out of 33 cases of NHL, few cases showed occasional atypical cell in marrow aspirate (but not diagnostic of marrow infiltration by lymphoma). In BMB, four cases of low grade B cell lymphoma (Fig. 5a and b), 1 case of Follicular lymphoma were detected. One case of Burkitt lymphoma diagnosed on IHC and unfortunately 02 cases could not be typed. None of the Hodgkins lymphoma showed marrow infiltration in aspiration. Among the total, Chronic lymphocytic leukemia (CLL/SLL) comprised of 16 cases. All cases of CCL/SLL were diagnosed in BMA. Among 42 cases of multiple myeloma (plasma cell dyscrasia) 41 cases were detected in BMA. One case of aspiration showed hypercellular marrow with poor cell trails showing occasional plasma cells and biopsy was diagnosed to be of multiple myeloma with marked plasmacytosis. Six cases of metastasis were encountered in biopsy out of which 2 (33.3%) were missed in aspiration.
Immunoglobulin G kappa multiple myeloma with the only initial manifestation of Raynaud’s phenomenon
Published in Scandinavian Journal of Rheumatology, 2020
C-C Chu, Y-H Chiu, M-H Lin, J-H Yeh, H-C Chen, S-Y Kuo
A 72-year-old woman who had been in robust health in the past presented with intermittent discoloration of her fingertips and toes accompanied by painful sensation (Figure 1A). Her symptoms worsened during winter. She denied dry eye, dry mouth, dysphagia, arthralgia, morning stiffness, skin rash, and photosensitivity. Physical examination revealed cyanosis with tenderness on the bilateral first toe and erythema on all fingertips. Normal pulsation on the radial and dorsalis pedis arteries and an elevated erythrocyte sedimentation rate (71 mm/h) were observed. Autoantibody screening was negative for anti-nuclear antibodies, anti-RNP antibody, anti-SM antibody, anti-RO/LA, anti-double-stranded DNA, normal complement component-3, and complement component-4. Urinalysis results and spot urine protein/creatinine ratio were unremarkable. RP with unknown aetiology was the first impression. Computed tomography angiography (CTA) of the bilateral lower limbs excluded peripheral artery disease. She underwent initial treatment with nifedipine combined with intravenous nitroglycerine and prostaglandin E1 for persistent symptoms. Her cyanosis, except that of her first toe, improved. Her left first toe was amputated owing to progressing gangrene complicated by refractory sepsis (Figure 1B). Furthermore, we evaluated other aetiologies of refractory RP, and serum protein electrophoresis revealed monoclonality with immunoglobulin G (IgG) kappa. The serum viscosity relative to water was 2.3. The amputated toe revealed necrotic tissue, which was negative for Congo red staining. Bone marrow biopsy revealed plasmacytosis (25%) in CD138-positive cells, which confirmed the diagnosis of multiple myeloma. She was referred to a haematologist and received bortezomib.