title: Immunohistological diagnosis of plasma cell myeloma based on cytoplasmic kappa/lambda ratio of CD138-positive plasma cells.
abstract: For differentiating reactive plasmacytosis from clonal plasma cell neoplasms such as plasma cell myeloma (PCM), it is important to determine the expression of the cytoplasmic light chain accurately. Through retrospective analysis, we studied the cytoplasmic kappa/lambda ratio of CD138-positive plasma cells in bone marrow from 50 patients with PCM and 50 controls by immunohistological analysis. The percentage of cytoplasmic light chain immunoreactive cells out of the total plasma cell population was shown by a novel quantitative image analysis approach using an Aperio ScanScope CS and the Membrane v9 algorithm. PCM cells were distinguished from normal plasma cells by cut-off levels between 0.35 and 5.5, a sensitivity of 100% and a specificity of 98.0%. Detection of the cytoplasmic kappa/lambda ratio of CD138-positive plasma cells could be a useful tool for simple, efficient and accurate diagnosis of PCM.
authors.affiliation: Department of Internal Medicine, Osaka Medical College,Osaka, Japan. in1304@poh.osaka-med.ac.jp
authors.forename: Shoko
authors.initials: S
authors.lastname: Nakayama-Ichiyama
authors.forename: Taiji
authors.initials: T
authors.lastname: Yokote
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hirata
authors.forename: Kazuki
authors.initials: K
authors.lastname: Iwaki
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Akioka
authors.forename: Takuji
authors.initials: T
authors.lastname: Miyoshi
authors.forename: Ayami
authors.initials: A
authors.lastname: Takayama
authors.forename: Uta
authors.initials: U
authors.lastname: Nishiwaki
authors.forename: Yuki
authors.initials: Y
authors.lastname: Masuda
authors.forename: Yasuichiro
authors.initials: Y
authors.lastname: Nishimura
authors.forename: Motomu
authors.initials: M
authors.lastname: Tsuji
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hanafusa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003593:Cytoplasm / Q000737:chemistry*; D005260:Female; D006801:Humans; D007145:Immunoglobulin kappa-Chains / Q000032:analysis*; D007146:Immunoglobulin lambda-Chains / Q000032:analysis*; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis*; D010950:Plasma Cells / Q000737:chemistry*; D053668:Syndecan-1 / Q000032:analysis*
chemical_list: D007145:Immunoglobulin kappa-Chains; D007146:Immunoglobulin lambda-Chains; C508241:SDC1 protein, human; D053668:Syndecan-1