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Case 204 - Discussion

Hematopathology Case

 

Plasma Cell Myeloma

  • Neoplastic plasma cells may show a variety of morphologic features, including mature, intermediate, immature, lymphoid, plasmablastic and anaplastic morphology. Therefore, it is probably worthwhile to perform CD138 immunostain if no apparent plasma cells are noted in the marrow. Please note, CD138 can be positive in carcinoma cells;

  • Also, solitary plasmacytoma may present at the extramedullary sites without typical clinical presentations or marrow involvement; occasionally, the tumor cells may not be plasma cell-appearing at all, which can resemble poorly differentiated carcinoma, sarcoma, melanoma or lymphoma. Therefore, plasmacytoma should be considered as one of the differential diagnoses for a wired tumor of unknown origin