Extranodal posttransplant plasmacytic hyperplasia with subsequent posttransplant plasmacytic malignancy: six-year interval case report and review of the literature.
Posttransplant lymphoproliferative disorders (PTLDs) represent a morphologic, immunophenotypic, and genotypic spectrum of disease. Most recently, Knowles et al divided PTLDs into 3 distinct categories: (1) plasmacytic hyperplasia, (2) polymorphic B-cell hyperplasia and polymorphic B-cell lymphoma, and (3) immunoblastic lymphoma and multiple myeloma. Although one form of PTLD may progress to another form, only 1 previous case has been reported in which multiple myeloma developed 14 months after an original diagnosis of plasmacytic hyperplasia. The type of solid organ transplant was not specified in that case. We report a post--cardiac transplant plasmacytic hyperplasia developing 7 years posttransplant. Six years subsequent to the plasmacytic hyperplasia, the patient developed a posttransplant plasmacytic malignancy, supported by morphology, flow cytometric immunophenotyping, and genotypic studies. Since we have no data to support disseminated bony disease or an abnormal serum protein, we have not used the term "multiple myeloma" for this case.
Dunphy
Cherie H
CH
Division of Hematopathology, St Louis University Health Sciences Center, Mo, USA. cdunphy@unch.unc.edu
Galambos
Csaba
C
Polski
Jacek M
JM
Evans
H Lance
HL
Gardner
Laura J
LJ
Grosso
Leonard E
LE
Montone
Kathleen T
KT
D004273:DNA, Neoplasm / Q000032:analysis; D005434:Flow Cytometry; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D006965:Hyperplasia / Q000209:etiology / Q000473:pathology; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D007150:Immunohistochemistry; D016130:Immunophenotyping; D008232:Lymphoproliferative Disorders / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010950:Plasma Cells / Q000473:pathology*; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications; D012367:RNA, Viral / Q000032:analysis
D004273:DNA, Neoplasm; C099537:Epstein-Barr virus encoded RNA 1; D007143:Immunoglobulin Heavy Chains; D012367:RNA, Viral