Yazarlar : Scripcaru G, Lade S, Stillwell R.

Yayın : Pathology

Yayın Yılı : 2014

Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/24557197

Konu : Lenfoma

Literatür İçeriği :

BACKGROUND AND AIM:

Isolated intranodal plasmacytomas are rare, but well described. When appearing as a localised neoplastic process they tend to have a favourable prognosis, in particular when IgA secreting. Follicular lymphomas with plasma cell or plasmacytoid differentiation are even less common, but also sporadically encountered in practice and the literature. We present a unique case in which the two entities are associated.

RESULTS:

This is the case of a 42-year-old who presented with isolated node lymphadenopathy in the submandibular area. The sections revealed that the node was partially infiltrated by sheets of plasma cells replacing the lymphoid stroma. While most had typical features of mature plasma cells with peripheral round nuclei with speckled chromatin and basophilic cytoplasm, there were frequent scattered immature forms showing binucleation, nuclear vesiculation and cytomegaly. Adjacent to this there was a grade I follicular lymphoma involving a small portion of the residual lymph node. Immunohistochemistry confirmed the presence of the two separate entities. Both plasma cell collection and the follicular lymphoma were lambda chain restricted.

CONCLUSIONS:

In this case we raise the possibility of an isolated plasmacytoma arising adjacent to a follicular lymphoma, as two separate entities rather than plasma cell differentiation in a follicular lymphoma. This would be supported by the extent of plasma cell over the lymphocytic proliferation, as well as the immunohistochemical pattern. Even if this is interpreted as plasma cell differentiation in a follicular lymphoma, its unusual presentation and pattern make it an intriguing and challenging diagnostic puzzle.

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