Plasma Cell Cheilitis: A Clinicopathological and Immunohistochemical Study of 13 Cases

BACKGROUND: Plasma cell cheilitis is an unusual benign plasma cell proliferative disease of an unknown etiology that typically presents on the lip. OBJECTIVE: The aim of this study was to investigate the clinicopathological characteristics of 13 cases of plasma cell cheilitis. METHODS: The present study investigated the clinical manifestations, treatment modalities, and outcome of 13 patients diagnosed with plasma cell cheilitis from 2011 to 2016 at Kangdong Sacred Heart Hospital and Hallym University Sacred Heart Hospital. Biopsy specimens of the all cases were evaluated using conventional hematoxylin and eosin staining with kappa and lambda immunoglobulin light chain immunohistochemistry. RESULTS: The age of the patients ranged from 39 to 86 years (mean, 64.7 years), with male predominance. Histopathologically, 61.5% and 38.5% of patients showed band-like and pan dermal plasmacytic infiltrates, respectively. Eosinophilic infiltration was noted in 69.2% of patients. All cases showed both kappa and lambda immunoglobulin light chain reactivities, and kappa predominance was confirmed in 9 patients (69.2%). A majority of the patients was treated with local therapy, such as intralesional steroid injection with topical tacrolimus. Among the 13 patients, plasma cell cheilitis completely resolved, partially resolved, and recurred in 3 (23.1%), 5 (38.5%), and 5 patients (38.5%), respectively. CONCLUSION: Plasma cell cheilitis presented as erosive edematous circumscribed patches or plaques affecting mainly the lower lip of elderly male patients. The majority of histopathology cases showed characteristic plasma cell aggregation on the upper dermis that was immunopositive for immunoglobulin light chain, with kappa predominance.

Kappa Chain Monoclonal Primary Cutaneous Plasmacytoma / 대한피부과학회지

Primary cutaneous plasmacytoma is a rare type of cutaneous B-cell lymphoma that arises primarily in the skin, and this is derived from clonally expanded plasma cells with various degrees of maturation and atypia. A 72-year-old man had an asymptomatic, solitary reddish to violaceous nodule on the back for about 4 months. The histologic finding of the skin biopsy specimen demonstrated an infiltration of variably matured plasma cells in the dermis, and these cells showed a monotypic expression of immunoglobulin kappa chains on immunohistochemical staining. Staging investigations excluded any extracutaneous manifestations of the disease. Only a few cases of primary cutaneous plasmacytoma have been published in the Korean dermatologic literature. Herein, we report on an interesting case of primary cutaneous plasmacytoma with monoclonality of kappa chains.

Role of serum ?/? ratio detection in multiple myeloma diagnosis / 国际检验医学杂志

Objective To explore the clinical value of the immune rate nephelometry (IRN)in detecting the rate of serum ? and ?,and diagnosing multiple myeloma.Methods Twenty-five cases of multiple myeloma (MM),28 cases of M protein sickness and 120 cases of healthy people were detected for the rate of serum ?/? by the Immage Protein Machine the results were analyzed.Results 0.8% of healthy people was positive, the positive rate of ? and ? type M protein sickness were 23.1% and 26.7% respectively, the positive rate of ? and ? type multiple myeloma was 92.3% and 100% respectively. Conclusion The method of IRN has high sensitivity and stability in detecting the light chain of serum ? and ? on/with the Immage Protein Machine.The accuracy value of prognosing MM with the rate of serum ? and ? is better.

Length diversity in CDR3 Domain of Immunoglobulin Kappa Chain during the Human Deelopment / 대한면역학회지

The third complementarity determining region (CDR3) of the immunoglobulin (Ig) kappa () chain is known to be located at the center of antigen binding groove and critical for antibody specificity. Ig chain has been characterized by limited junctional diversity due to the absence of N-region addition resulting in relative conservation of CDR3 lengths with 9 or 10 amino acids. CDR3 region of 11 amino acids is only possible with N-region addition. Recently, x transcripts with 11 amino acids CDR3 was found to be expressed in normal individuals, and in autoimrnune disease such as rheumatoid arthritis, the fraction of 11 amino acids CDR3 of humkv325-derived chains was overexpressed compared to conventional adult peripheral B cells. However, the significance of this bias is difficult to interpret without a clear understanding of normal repertoire of CDR3 length during development. The purpose of this study is to determine whether developmental regulation of CDR3 amino acids codon lengths exists in chains expressed in the fetal liver, cord blood, and adult peripheral blood lymphocytes (PBL). Lymphocytes were seperated from fetal liver, cord blood and adult PBL and cDNA was generated from extracted mRNA. PCR-based CDR3 finger- printing assay was performed with VI-IV family specific primers. CDR3 length diversity of Ig x chain increases as the development proceeds. The length diversity most frequently occured in Vlll family derived transcripts including 11 amino acids CDR3. transcripts with 11 amino acids CDR3 were consitently expressed in both fetal and adult Ig repertoire. These results support the hypothesis that v chain CDR3 length is developmentally regulated and implicates the diversity of antigen-antibody specificity generation.

A Case of Waldenstrom's Macroglobulinemia with Multiple Punched-out, Osteolytic Lesions / 대한혈액학회지

Waldenstr m's macroglobulinemia (WM) is a chronic lymphoproliferative disorder characterized by the association of serum monoclonal IgM and marrow infiltration by lymphoid population. A 69-year-old man was first seen for evaluation of anemia. He had complained of generalized weakness and exertional dyspnea. On physical examination there was generalized lymphadenopathy, palpable liver and spleen. He did not show signs and symptoms of hyperviscosity. Skull X-ray demonstrated multiple punched-out, osteolytic lesions. The total serum protein concentration was 10.6g/dL, with a fast gamma peak accounting for 48.3% of the total. The peak was identified as an IgM of the kappa chain type by immunoelectrophoresis. Bence-Jones protein (kappa type) was found in the urine. A Sia test gave positive result. The patient's serum contained a pyroglobulin. Serum viscosity was 5.3. The bone marrow aspirate and biopsy showed infiltration by atypical lymphocytes (about 90% of all nucleated cells), plasmacytic lymphocytes, and plasma cells. By flow cytometric analysis, these cells expressed CD19 (54%), CD20 (80.5%), and CD38 (92%), but did not express CD3, CD5, and CD10. Biopsy specimen from cervical lymph node demonstrated proliferation of abnormal lymphoid cells, composed of a similar population of cells seen in the bone marrow. He was treated with cyclophosphamide, vincristine, and prednisolone and now he improves slightly in clinical and laboratory aspects.

PREPARATION AND PRELIMINARY CLINICAL APPLICATION OF McAb AGAINST HUMAN IgK AND Ig? / 解放军医学杂志

Five hybridoma cell lines have been developed by fusion of SP2/O or NS-1 myeloma cell with splenocytes of BALb/c mice immunized with colostrum and serum IgA and screened by means of ELI-SA sandwich method. Of these, three lines (1Dl, 5C3, 11A7) secreted antibodies against human free A chains and combined A light chains, while the other two lines (4G12. 14A6) against human free K and combined K light chains. The 4G12 reacted better with combined K chains than with free K chains. These cell lines were stable to secrete specific McAb in long term culture for one year, and after storage in liquid nitrogen for ten months as well. With competitive ELISA using solid phase antigen, McAbs 4G12 and 14A6 were proved to react with different antigen epitopes, while McAbs IDl, 5C3 and 11A7 reacted with same antigen epitopes. These McAbs are good in both specificity and sensitivity for detection of paraproteins and Bence-Jones proteins. Mixed McAbs of 4G12-HRP and 1D1-HRP could be used to detect VCA and EA of EB virus satisfactorily. Preliminary application to the detection of antinuclar antibodies was also successful.