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Neural cell adhesion molecule expression in plasma cells in bone marrow biopsies and aspirates allows discrimination between multiple myeloma, monoclonal gammopathy of uncertain significance and polyclonal plasmacytosis.
Histopathology. 2004 Apr; 44(4):375-80.H

Abstract

AIMS

Differential diagnosis between multiple myeloma (MM), monoclonal gammopathy of uncertain significance (MGUS), and polyclonal plasmacytosis may be difficult in cases with not much bone marrow infiltration. Normal plasma cells express the antigens CD138, CD38, CD19, CD10 and D-related human leucocyte antigen (HLA-DR). Myelomatous plasma cells lack B lymphoid-associated markers and may express cell surface antigens associated with other haematopoietic lineages such as NCAM/CD56 (neural cell adhesion molecule). Recently, a monoclonal antibody, anti-CD56, has become available that can be used in fixed tissues embedded in paraffin, and it has been reported that osteoblastic cells of trabecular bone strongly express NCAM/CD56.

METHODS AND RESULTS

We analysed NCAM molecule expression in 35 samples from patients with plasma cell disorders: 14 cases of MM, 16 cases of MGUS, and five cases of polyclonal plasmacytosis using immunohistochemistry in parallel in bone marrow core biopsies processed routinely and in bone marrow smears from the same patients. Of the MM samples 78% were CD56+ in smears and 92% positive in biopsies. We did not find strong CD56 expression in MGUS samples. One of five samples of polyclonal plasmacytosis was CD56+. A case was considered to be positive for CD56 expression if >50% of the CD138+ plasma cells expressed NCAM with an intensity on a par with that of the osteoblasts.

CONCLUSION

We conclude that CD56 antibody is a very useful marker in the study of plasma cell proliferation in bone marrow biopsies and in bone marrow aspirates and is a great help in discriminating between MM, MGUS, and polyclonal plasmacytosis, especially in those cases with low infiltration.

Authors+Show Affiliations

Department of Pathology, Hospital Ramón y Cajal, Madrid, Spain.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15049904

Citation

Martín, P, et al. "Neural Cell Adhesion Molecule Expression in Plasma Cells in Bone Marrow Biopsies and Aspirates Allows Discrimination Between Multiple Myeloma, Monoclonal Gammopathy of Uncertain Significance and Polyclonal Plasmacytosis." Histopathology, vol. 44, no. 4, 2004, pp. 375-80.
Martín P, Santón A, Bellas C. Neural cell adhesion molecule expression in plasma cells in bone marrow biopsies and aspirates allows discrimination between multiple myeloma, monoclonal gammopathy of uncertain significance and polyclonal plasmacytosis. Histopathology. 2004;44(4):375-80.
Martín, P., Santón, A., & Bellas, C. (2004). Neural cell adhesion molecule expression in plasma cells in bone marrow biopsies and aspirates allows discrimination between multiple myeloma, monoclonal gammopathy of uncertain significance and polyclonal plasmacytosis. Histopathology, 44(4), 375-80.
Martín P, Santón A, Bellas C. Neural Cell Adhesion Molecule Expression in Plasma Cells in Bone Marrow Biopsies and Aspirates Allows Discrimination Between Multiple Myeloma, Monoclonal Gammopathy of Uncertain Significance and Polyclonal Plasmacytosis. Histopathology. 2004;44(4):375-80. PubMed PMID: 15049904.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neural cell adhesion molecule expression in plasma cells in bone marrow biopsies and aspirates allows discrimination between multiple myeloma, monoclonal gammopathy of uncertain significance and polyclonal plasmacytosis. AU - Martín,P, AU - Santón,A, AU - Bellas,C, PY - 2004/3/31/pubmed PY - 2004/12/24/medline PY - 2004/3/31/entrez SP - 375 EP - 80 JF - Histopathology JO - Histopathology VL - 44 IS - 4 N2 - AIMS: Differential diagnosis between multiple myeloma (MM), monoclonal gammopathy of uncertain significance (MGUS), and polyclonal plasmacytosis may be difficult in cases with not much bone marrow infiltration. Normal plasma cells express the antigens CD138, CD38, CD19, CD10 and D-related human leucocyte antigen (HLA-DR). Myelomatous plasma cells lack B lymphoid-associated markers and may express cell surface antigens associated with other haematopoietic lineages such as NCAM/CD56 (neural cell adhesion molecule). Recently, a monoclonal antibody, anti-CD56, has become available that can be used in fixed tissues embedded in paraffin, and it has been reported that osteoblastic cells of trabecular bone strongly express NCAM/CD56. METHODS AND RESULTS: We analysed NCAM molecule expression in 35 samples from patients with plasma cell disorders: 14 cases of MM, 16 cases of MGUS, and five cases of polyclonal plasmacytosis using immunohistochemistry in parallel in bone marrow core biopsies processed routinely and in bone marrow smears from the same patients. Of the MM samples 78% were CD56+ in smears and 92% positive in biopsies. We did not find strong CD56 expression in MGUS samples. One of five samples of polyclonal plasmacytosis was CD56+. A case was considered to be positive for CD56 expression if >50% of the CD138+ plasma cells expressed NCAM with an intensity on a par with that of the osteoblasts. CONCLUSION: We conclude that CD56 antibody is a very useful marker in the study of plasma cell proliferation in bone marrow biopsies and in bone marrow aspirates and is a great help in discriminating between MM, MGUS, and polyclonal plasmacytosis, especially in those cases with low infiltration. SN - 0309-0167 UR - https://www.unboundmedicine.com/medline/citation/15049904/Neural_cell_adhesion_molecule_expression_in_plasma_cells_in_bone_marrow_biopsies_and_aspirates_allows_discrimination_between_multiple_myeloma_monoclonal_gammopathy_of_uncertain_significance_and_polyclonal_plasmacytosis_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0309-0167&date=2004&volume=44&issue=4&spage=375 DB - PRIME DP - Unbound Medicine ER -