Unusual biclonal IgA plasma cell myeloma with aberrant expression of high-risk immunophenotypes: first report of a new diagnostic and clinical challenge
IgA plasma cell myeloma (PCM) has been linked to molecular abnormalities that confer a higher risk for adverse patient outcomes. However, since IgA PCM only accounts for approximately 20% of all PCM, there are very few reports on high-risk IgA PCM. Moreover, no such reports are found on the more inf...
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| Format: | Article |
| Language: | English |
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Korean Society of Pathologists & the Korean Society for Cytopathology
2023-03-01
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| Series: | Journal of Pathology and Translational Medicine |
| Subjects: | |
| Online Access: | http://jpatholtm.org/upload/pdf/jptm-2023-02-07.pdf |
| _version_ | 1797867252062617600 |
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| author | Carlos A. Monroig-Rivera Clara N. Finch Cruz |
| author_facet | Carlos A. Monroig-Rivera Clara N. Finch Cruz |
| author_sort | Carlos A. Monroig-Rivera |
| collection | DOAJ |
| description | IgA plasma cell myeloma (PCM) has been linked to molecular abnormalities that confer a higher risk for adverse patient outcomes. However, since IgA PCM only accounts for approximately 20% of all PCM, there are very few reports on high-risk IgA PCM. Moreover, no such reports are found on the more infrequent biclonal IgA PCM. Hence, we present a 65-year-old Puerto Rican female with acute abdominal pain, concomitant hypercalcemia, and acute renal failure. Protein electrophoresis with immunofixation found high IgA levels and detected a biclonal IgA gammopathy with kappa specificity. Histomorphologically, bone marrow showed numerous abnormal plasma cells (32%) replacing over 50% of the marrow stroma. Immunophenotyping analysis detected CD45-negative plasma cells aberrantly expressing CD33, CD43, OCT-2, and c-MYC. Chromosomal analysis revealed multiple abnormalities including the gain of chromosome 1q. Thus, we report on an unusual biclonal IgA PCM and the importance of timely diagnosing aggressive plasma cell neoplasms. |
| first_indexed | 2024-04-09T23:37:18Z |
| format | Article |
| id | doaj.art-7842c00cd24743dfb8c82af8bcb6c3a4 |
| institution | Directory Open Access Journal |
| issn | 2383-7837 2383-7845 |
| language | English |
| last_indexed | 2024-04-09T23:37:18Z |
| publishDate | 2023-03-01 |
| publisher | Korean Society of Pathologists & the Korean Society for Cytopathology |
| record_format | Article |
| series | Journal of Pathology and Translational Medicine |
| spelling | doaj.art-7842c00cd24743dfb8c82af8bcb6c3a42023-03-20T04:41:42ZengKorean Society of Pathologists & the Korean Society for CytopathologyJournal of Pathology and Translational Medicine2383-78372383-78452023-03-0157213213710.4132/jptm.2023.02.0717065Unusual biclonal IgA plasma cell myeloma with aberrant expression of high-risk immunophenotypes: first report of a new diagnostic and clinical challengeCarlos A. Monroig-Rivera0Clara N. Finch Cruz1 School of Medicine, Ponce Health Sciences University, Ponce, Puerto Rico, USA Department of Basic Sciences, School of Medicine - Ponce Health Sciences University, Ponce, Puerto Rico, USAIgA plasma cell myeloma (PCM) has been linked to molecular abnormalities that confer a higher risk for adverse patient outcomes. However, since IgA PCM only accounts for approximately 20% of all PCM, there are very few reports on high-risk IgA PCM. Moreover, no such reports are found on the more infrequent biclonal IgA PCM. Hence, we present a 65-year-old Puerto Rican female with acute abdominal pain, concomitant hypercalcemia, and acute renal failure. Protein electrophoresis with immunofixation found high IgA levels and detected a biclonal IgA gammopathy with kappa specificity. Histomorphologically, bone marrow showed numerous abnormal plasma cells (32%) replacing over 50% of the marrow stroma. Immunophenotyping analysis detected CD45-negative plasma cells aberrantly expressing CD33, CD43, OCT-2, and c-MYC. Chromosomal analysis revealed multiple abnormalities including the gain of chromosome 1q. Thus, we report on an unusual biclonal IgA PCM and the importance of timely diagnosing aggressive plasma cell neoplasms.http://jpatholtm.org/upload/pdf/jptm-2023-02-07.pdfbiclonal igaplasma cell myelomaabdominal painhigh-risk phenotypesprognosis |
| spellingShingle | Carlos A. Monroig-Rivera Clara N. Finch Cruz Unusual biclonal IgA plasma cell myeloma with aberrant expression of high-risk immunophenotypes: first report of a new diagnostic and clinical challenge Journal of Pathology and Translational Medicine biclonal iga plasma cell myeloma abdominal pain high-risk phenotypes prognosis |
| title | Unusual biclonal IgA plasma cell myeloma with aberrant expression of high-risk immunophenotypes: first report of a new diagnostic and clinical challenge |
| title_full | Unusual biclonal IgA plasma cell myeloma with aberrant expression of high-risk immunophenotypes: first report of a new diagnostic and clinical challenge |
| title_fullStr | Unusual biclonal IgA plasma cell myeloma with aberrant expression of high-risk immunophenotypes: first report of a new diagnostic and clinical challenge |
| title_full_unstemmed | Unusual biclonal IgA plasma cell myeloma with aberrant expression of high-risk immunophenotypes: first report of a new diagnostic and clinical challenge |
| title_short | Unusual biclonal IgA plasma cell myeloma with aberrant expression of high-risk immunophenotypes: first report of a new diagnostic and clinical challenge |
| title_sort | unusual biclonal iga plasma cell myeloma with aberrant expression of high risk immunophenotypes first report of a new diagnostic and clinical challenge |
| topic | biclonal iga plasma cell myeloma abdominal pain high-risk phenotypes prognosis |
| url | http://jpatholtm.org/upload/pdf/jptm-2023-02-07.pdf |
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