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Lymphoplasmacytic Lymphoma With a Non-IgM Paraprotein Shows Clinical and Pathologic Heterogeneity and May Harbor MYD88 L265P Mutations.
Am J Clin Pathol. 2016 Jun; 145(6):843-51.AJ

Abstract

OBJECTIVES

Lymphoplasmacytic lymphoma (LPL) with non-immunoglobulin M (IgM) paraproteinemia remains poorly understood. The goal of this study was to investigate the clinicopathologic features of LPL in the bone marrow in patients with immunoglobulin G (IgG) or immunoglobulin A (IgA) paraproteins and evaluate MYD88 L265P mutation status to determine the relationship of these cases to Waldenström macroglobulinemia (WM).

METHODS

Bone marrows from LPL cases with IgG or IgA paraproteins diagnosed between January 1, 2007, and June 30, 2014, were retrieved from the clinical archive. Clinicopathologic features were retrospectively reviewed. MYD88 L265P mutation status was assessed by allele-specific polymerase chain reaction prospectively on all cases.

RESULTS

Of 27 cases, four were reclassified as multiple myeloma, all MYD88 mutation negative. MYD88 L265P mutations were present in 10 (43%) of 23 remaining cases. No association between MYD88 status and bone marrow morphologic or phenotypic features, including the presence of Dutcher bodies, mast cells, expression of CD19 by plasma cells, or hemosiderin, was identified, although these features were present in a subset of cases, similar to WM. Clinical features of WM such as hyperviscosity were uncommon in this group and did not correlate with MYD88 status.

CONCLUSIONS

Non-IgM LPLs are a clinically and pathologically heterogeneous group and often harbor MYD88 L265P mutation, albeit at a lower rate than classic WM. MYD88 status does not correlate with any specific pathologic or clinical manifestations.

Authors+Show Affiliations

From the Division of Hematopathology rebecca.king98@gmail.com.Department of Hematology.Department of Hematology.Division of Laboratory Genetics, Mayo Clinic, Rochester, MN.From the Division of Hematopathology.From the Division of Hematopathology.From the Division of Hematopathology.Department of Hematology.Department of Hematology.Department of Hematology.From the Division of Hematopathology.From the Division of Hematopathology.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27329639

Citation

King, Rebecca L., et al. "Lymphoplasmacytic Lymphoma With a Non-IgM Paraprotein Shows Clinical and Pathologic Heterogeneity and May Harbor MYD88 L265P Mutations." American Journal of Clinical Pathology, vol. 145, no. 6, 2016, pp. 843-51.
King RL, Gonsalves WI, Ansell SM, et al. Lymphoplasmacytic Lymphoma With a Non-IgM Paraprotein Shows Clinical and Pathologic Heterogeneity and May Harbor MYD88 L265P Mutations. Am J Clin Pathol. 2016;145(6):843-51.
King, R. L., Gonsalves, W. I., Ansell, S. M., Greipp, P. T., Frederick, L. A., Viswanatha, D. S., He, R., Kyle, R. A., Gertz, M. A., Kapoor, P., Morice, W. G., & Howard, M. T. (2016). Lymphoplasmacytic Lymphoma With a Non-IgM Paraprotein Shows Clinical and Pathologic Heterogeneity and May Harbor MYD88 L265P Mutations. American Journal of Clinical Pathology, 145(6), 843-51. https://doi.org/10.1093/ajcp/aqw072
King RL, et al. Lymphoplasmacytic Lymphoma With a Non-IgM Paraprotein Shows Clinical and Pathologic Heterogeneity and May Harbor MYD88 L265P Mutations. Am J Clin Pathol. 2016;145(6):843-51. PubMed PMID: 27329639.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lymphoplasmacytic Lymphoma With a Non-IgM Paraprotein Shows Clinical and Pathologic Heterogeneity and May Harbor MYD88 L265P Mutations. AU - King,Rebecca L, AU - Gonsalves,Wilson I, AU - Ansell,Stephen M, AU - Greipp,Patricia T, AU - Frederick,Lori A, AU - Viswanatha,David S, AU - He,Rong, AU - Kyle,Robert A, AU - Gertz,Morie A, AU - Kapoor,Prashant, AU - Morice,William G, AU - Howard,Matthew T, Y1 - 2016/06/21/ PY - 2016/6/23/entrez PY - 2016/6/23/pubmed PY - 2017/2/24/medline KW - Bone marrow KW - IgA KW - IgG KW - Lymphoplasmacytic lymphoma KW - MYD88 KW - Non-IgM KW - Paraprotein KW - Waldenström macroglobulinemia SP - 843 EP - 51 JF - American journal of clinical pathology JO - Am. J. Clin. Pathol. VL - 145 IS - 6 N2 - OBJECTIVES: Lymphoplasmacytic lymphoma (LPL) with non-immunoglobulin M (IgM) paraproteinemia remains poorly understood. The goal of this study was to investigate the clinicopathologic features of LPL in the bone marrow in patients with immunoglobulin G (IgG) or immunoglobulin A (IgA) paraproteins and evaluate MYD88 L265P mutation status to determine the relationship of these cases to Waldenström macroglobulinemia (WM). METHODS: Bone marrows from LPL cases with IgG or IgA paraproteins diagnosed between January 1, 2007, and June 30, 2014, were retrieved from the clinical archive. Clinicopathologic features were retrospectively reviewed. MYD88 L265P mutation status was assessed by allele-specific polymerase chain reaction prospectively on all cases. RESULTS: Of 27 cases, four were reclassified as multiple myeloma, all MYD88 mutation negative. MYD88 L265P mutations were present in 10 (43%) of 23 remaining cases. No association between MYD88 status and bone marrow morphologic or phenotypic features, including the presence of Dutcher bodies, mast cells, expression of CD19 by plasma cells, or hemosiderin, was identified, although these features were present in a subset of cases, similar to WM. Clinical features of WM such as hyperviscosity were uncommon in this group and did not correlate with MYD88 status. CONCLUSIONS: Non-IgM LPLs are a clinically and pathologically heterogeneous group and often harbor MYD88 L265P mutation, albeit at a lower rate than classic WM. MYD88 status does not correlate with any specific pathologic or clinical manifestations. SN - 1943-7722 UR - https://www.unboundmedicine.com/medline/citation/27329639/Lymphoplasmacytic_Lymphoma_With_a_Non_IgM_Paraprotein_Shows_Clinical_and_Pathologic_Heterogeneity_and_May_Harbor_MYD88_L265P_Mutations_ L2 - https://academic.oup.com/ajcp/article-lookup/doi/10.1093/ajcp/aqw072 DB - PRIME DP - Unbound Medicine ER -