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Washington University Experience | NEOPLASMS (HEMATOLYMPHOID) | Plasmacytoma | 7G2 Plasma cell neoplasia (Case 7) ISH Lambda 10X
In situ hybridization shows that there is kappa light chain staining (7G1), when compared to the lambda light chain (7G2) (>10:1 for kappa:lambda ratio). ---- Comment: The overall findings are best classified as a neoplasm with plasmacytic differentiation. The differential diagnosis of this neoplasm includes a plasma cell neoplasm (favored because of the strong CD138 expression, kappa light chain restriction, and relative lack of CD20) versus a non-Hodgkin lymphoma with plasmacytic differentiation, such as a marginal zone lymphoma. These findings were correlated with appropriate serologic studies (for a plasma cell neoplasm), imaging and physical findings for splenomegaly or lymphadenopathy (for non-Hodgkin lymphoma).
