Assessment of bone marrow plasma cell infiltrates in multiple myeloma: the added value of CD138 immunohistochemistry.
Assessment of bone marrow involvement by malignant plasma cells is an important element in the diagnosis and follow-up of patients with multiple myeloma and other plasma cell dyscrasias. Microscope-based differential counts of bone marrow aspirates are used as the primary method to evaluate bone marrow plasma cell percentages. However, multiple myeloma is often a focal process, a fact that impacts the accuracy and reliability of the results of bone marrow plasma cell percentages obtained by differential counts of bone marrow aspirate smears. Moreover, the interobserver and intraobserver reproducibility of counting bone marrow plasma cells microscopically has not been adequately tested. CD138 allows excellent assessment of plasma cell numbers and distribution in bone marrow biopsies. We compared estimates of plasma cell percentages in bone marrow aspirates and in hematoxylin-eosin- and CD138-stained bone marrow biopsy sections (CD138 sections) in 79 bone marrows from patients with multiple myeloma. There was a notable discrepancy in bone marrow plasma cell percentages using the different methods of observation. In particular, there was a relatively poor concordance of plasma cell percentage estimation between aspirate smears and CD138 sections. Estimates of plasma cell percentage using CD138 sections demonstrated the highest interobserver concordance. This observation was supported by computer-assisted image analysis. In addition, CD138 expression highlighted patterns of plasma cell infiltration indicative of neoplasia even in the absence of plasmacytosis. We conclude that examination of CD138 sections should be considered for routine use in the estimation of plasma cell load in the bone marrow.
Al-Quran
Samer Z
SZ
Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Box 100275, Gainesville, FL 32610-0275, USA. salquran@ufl.edu
Yang
Lijun
L
Magill
James M
JM
Braylan
Raul C
RC
Douglas-Nikitin
Vonda K
VK
D001854:Bone Marrow Cells / Q000378:metabolism* / Q000473:pathology; D001856:Bone Marrow Examination; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007150:Immunohistochemistry; D009101:Multiple Myeloma / Q000378:metabolism* / Q000473:pathology*; D015588:Observer Variation; D010950:Plasma Cells / Q000378:metabolism* / Q000473:pathology; D011379:Prognosis; D053668:Syndecan-1 / Q000096:biosynthesis*
D053668:Syndecan-1
Am J Pathol. 1998 Jun;152(6):1655-65
9626070
Leuk Lymphoma. 1999 Jun;34(1-2):35-43
10350330
Blood. 1999 Jul 15;94(2):701-12
10397737
Bone Marrow Transplant. 1999 Sep;24(5):497-503
10482933
Haematologica. 2005 Aug;90(8):1147-9
16079123
Br J Haematol. 2006 Feb;132(4):410-51
16412016
Haematologica. 2006 Jul;91(7):972-5
16818287
Arch Pathol Lab Med. 2007 Jun;131(6):951-5
17550325
Psychol Bull. 1979 Mar;86(2):420-8
18839484
Am J Clin Pathol. 2001 Jan;115(1):127-35
11190798
Hum Pathol. 1999 Dec;30(12):1405-11
10667416
Hematol Oncol Clin North Am. 1999 Dec;13(6):1295-314, xi
10626152
Mod Pathol. 1999 Dec;12(12):1101-6
10619261
Mod Pathol. 2001 Oct;14(10):1052-8
11598177
Am J Hematol. 2001 Dec;68(4):269-75
11754416
Tumour Biol. 2001 Nov-Dec;22(6):390-6
11786733
Blood. 1998 Apr 15;91(8):2679-88
9531576
Leuk Lymphoma. 1996 Sep;23(1-2):33-41
9021683
Eur J Haematol. 1995 Mar;54(3):137-46
7720832
J Biol Chem. 1995 Mar 10;270(10):5077-83
7890615
J Biol Chem. 1994 Aug 5;269(31):20013-9
8051085
J Clin Pathol. 1994 May;47(5):418-22
7517959
Hum Pathol. 1994 Mar;25(3):308-18
8150462
Histopathology. 1993 May;22(5):423-8
7688339
Blood. 1993 Feb 1;81(3):767-74
8427968
Hematol Pathol. 1987;1(1):35-43
3504429
Eur J Haematol Suppl. 1989;51:52-9
2627992
Br J Haematol. 1992 Sep;82(1):46-9
1419801
Blood. 2002 Nov 1;100(9):3095-100
12384404
Br J Haematol. 2003 Jun;121(5):749-57
12780789
Anal Cell Pathol. 2003;25(4):167-71
14501083
Am J Clin Pathol. 2004 Feb;121(2):254-63
14983940
Br J Haematol. 1982 Jul;51(3):361-75
7104223
Am J Clin Pathol. 1987 Mar;87(3):342-55
3825999
Virchows Arch A Pathol Anat Histopathol. 1988;412(6):553-62
3129867