Fever ; Humans ; Plasma Cells ; pathology ; Thrombocytopenia ; diagnosis ; pathology

OBJECTIVE: to analyze the effect of circulating plasma cells(CPC) on the prognosis of patients with multiple myeloma(MM) in the era of new drugs, and to explore the new definition standard of primary plasma cell leukemia(pPCL). METHODS: The clinical data of 321 patients with newly diagnosed MM and 21 patients with pPCL admitted to our hospital from January 2014 to May 2022 were retrospectively analyzed. According to the proportion of CPC in peripheral blood smears, all patients were divided into 4 groups: CPC 0% group(211 cases), CPC 1%-4% group(69 cases), CPC 5%-19% group(41 cases) and CPC≥20% group(21 cases). The clinical features of patients in each group were compared and the prognosis fators was analyzed. RESULTS: The median OS of the four groups were 44.5,21.3,24.6 and 12.8 months, respectively. Among them, 295 patients(86.3%) were treated with new drugs, and the median OS of the four groups were not reached, 26.7, 24.6 and 14.9 months, respectively. As the survival curves of CPC 5%-19% group and CPC≥20% group were similar, the patients were divided into CPC<5% group and CPC≥5% group, the median OS of CPC<5% group was better than that in CPC≥5% (43.5 vs 22.3 months, P<0.001). In addition, the median OS of patients in the CPC 1%-4% group was also significantly lower than that in the CPC 0% group and similar to that in the CPC≥5% group. Multivariate analysis showed that 1%-4% CPC was an independent risk factor for the OS of patients with CPC<5%. The patients with CPC<5% were stratified by R-ISS staging, and the OS of R-ISS stage Ⅰ or stage Ⅱ with 1%-4% CPC was similar to that of R-ISS stage Ⅲ. The newly defined pPCL patients showed increased tumor load and obvious invasive characteristics. Multivariate analysis showed no independent prognostic factors for pPCL, and high-risk cytogenetic abnormalities(HRCA) had no significant effect on the prognosis. CONCLUSION The validity of IMWG's new pPCL definition standard was verified, and it was found that the survival of MM with 1%-4% CPC also is poor and the prognosis is very close to pPCL. In addition, the newly defined pPCL has unique clinical and biological characteristics.
Humans ; Multiple Myeloma/pathology* ; Plasma Cells/pathology* ; Retrospective Studies ; Prognosis ; Leukemia, Plasma Cell/diagnosis*

Adult ; Humans ; Male ; Plasma Cells ; pathology ; Skin Diseases ; diagnosis

Multiple myeloma (MM) is a malignancy of terminally differentiated monoclonal B cells, which is characterized by the presentation of malignant plasma cell within the bone marrow and the secretion of monoclonal immunoglobulin. Extramedullary disease (EMD) may be found either at diagnosis or during therapy of these patients. For the patients with EMD, the response to conventional chemotherapy is poor and the prognosis is unfavorable. This review mainly discusses the research progress in the pathogenesis, the clinical feature, the therapy and the prognosis of MM with EMD.
Bone Marrow ; pathology ; Humans ; Multiple Myeloma ; pathology ; Plasma Cells ; pathology ; Prognosis

OBJECTIVETo evaluate the clinical significance of breast duct endoscope for plasma cell mastitis.

METHODSBreast duct endoscope was performed on 250 patients with nipple discharge. The characters of 95 cases of plasma cell mastitis under the breast duct endoscope were analyzed and studied.

RESULTSAmong the 95 cases with plasma cell mastitis, 21 were in type I, 43 in type II, 18 in type III and 13 in type IV. Eighty-three cases were treated with no-operation treatment, and 45 completely released, 38 partly released. There were 5 cases with middle to serious atypical hyperplasia in 12 cases treated with operation, that were all confirmed by pathological examination.

CONCLUSIONIn patients with plasma cell mastitis, clear diagnosis can be made through breast duct endoscope, and the breast duct with lesions could be positioned. It is a necessary assistant method for patients to avoid biopsy or decrease the biopsy range.

Adolescent ; Adult ; Aged ; Breast ; pathology ; Endoscopy ; Female ; Humans ; Mastitis ; pathology ; Middle Aged ; Plasma Cells ; pathology

Humans ; Plasma Cells/pathology* ; Hyperplasia/pathology* ; Immunoblastic Lymphadenopathy ; B-Lymphocytes/pathology* ; Lymphoma, T-Cell

Sjogren's syndrome (SS) is an autoimmune disorder in which lymphocytes infiltrate the exocrine glands, resulting in the development of sicca symptoms. Lymphocytes may also invade various other organs and cause diverse symptoms. Interstitial pneumonia has been observed frequently in SS patients. Typically, the pneumonia responds well to systemic steroids, and fatal cases are rare. We experienced a case of lymphocytic pneumonia accompanied by SS and treated with cyclophosphamide pulse therapy, and we present details of the case herein.
Adult ; Humans ; Lung/*pathology ; Lung Diseases, Interstitial/drug therapy/*pathology ; Lymphocytes/*pathology ; Male ; Plasma Cells/pathology ; Sjogren's Syndrome/*pathology

Aged ; Cytoplasm ; Cytoplasmic Granules ; Female ; Humans ; Multiple Myeloma ; pathology ; Plasma Cells ; pathology

The multiple myeloma (MM), the second most common hematologic malignancy, is malignant proliferative disease of plasma cells. Although the application of many targeted drugs has significantly prolonged the survival time of MM patients, it is still an incurable disease. In recent years, the immunosuppression caused by interaction between tumor microenvironment(TME) and tumor cells has attracted people's attention gradually. As a kind of immunosuppressive cells in TME, regulatory T cells (Treg) play an important role in the progress of MM. Treg is related to the proliferation and metastasis of tumors, and can lead to the progress of MM by promoting the angiogenesis and generating immunosuppressive TME. In this review, we briefly summarized the latest research progress on the impact of Treg on the pathogenesis of MM.
Humans ; Multiple Myeloma/pathology* ; T-Lymphocytes, Regulatory/pathology* ; Immune Tolerance ; Plasma Cells/pathology* ; Immunosuppression Therapy ; Tumor Microenvironment

Plasma cell leukemia (PCL) is an aggressive form of multiple myeloma where there is hematogenous spread of abnormal plasma cells into the periphery. This is opposed to multiple myeloma, where the abnormal plasma cells stay in the bone marrow. PCL is more common in males than females, and is also more common in African-Americans than Caucasians. Signs and symptoms of PCL include, but are not limited to, renal insufficiency, hypercalcemia, anemia, lytic bone lesions, thrombocytopenia, hepatomegaly, and splenomegaly. Here, we discussed a case of a 71-year-old Caucasian female recently diagnosed with primary PCL with radiographic features of this disease throughout the body, with an emphasis on the maxillofacial skeleton and relevance from a dental standpoint.
Aged ; Anemia ; Bone Marrow ; Female ; Hepatomegaly ; Humans ; Hypercalcemia ; Leukemia, Plasma Cell* ; Male ; Maxilla* ; Multiple Myeloma ; Pathology ; Plasma Cells* ; Plasma* ; Renal Insufficiency ; Skeleton ; Splenomegaly ; Thrombocytopenia