Very difficult to get any information about this topic online. I hope someone can clear things for us a bit.
Ian was diagnosed with light chain ONLY myeloma, and we are struggling a bit to understand the meaning of some blood reports we have at home.
Film report says: Normal red cell morphology. Normal lymphocytes and occasional plasmacytoid lymphocytes.
Plasma cells are restricted to the BM and not usually seen in circulating blood, and these are lymphocytes, so does that mean that his myeloma is evolving into plasma cell leukemia? What is the meaning of plasmacytoid lymphocytes?
All the articles we found seem to be related to lymphoma and other diseases and not to myeloma.
Thank you
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johanna - Name: Joanna
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: august 2012
- Age at diagnosis: 60
Re: Light chain myeloma with plasmacytoid lymphocytes
Unfortunately, without more information any real statement is difficult. I am also assuming that the "film" means a peripheral blood smear.
You are correct myeloma is generally a bone marrow restricted disease. Further, when plasma cells (non-"plasmacytoid" lymphocytes) are observed in the peripheral blood at greater than 20% of the white cell population this is termed PCL (plasma cell leukemia). Although arguments can be made regarding that hard cut off.
"Plasmacytoid" is a term that is used by pathologists to describe the morphology (what the cells look like). It is more than likely a benign finding that is sometimes even be related to the processing of the slide prior to review. And in someone with myeloma the pathologist may over call it to bring to the attention of oncologist. Reactive lymphocytes can have that appearance (infections or other active process). Even myeloma cells (in the marrow)- especially t(11;14) myeloma- can look a little immature and have that appearance. Other lymphomas can also have that appearance (marginal zone, mantle cell, LPL). However, this not likely in your case. But it is something that I would bring to your multiple myeloma Drs attention, if not already.
In your case it is likely nothing at all.
You are correct myeloma is generally a bone marrow restricted disease. Further, when plasma cells (non-"plasmacytoid" lymphocytes) are observed in the peripheral blood at greater than 20% of the white cell population this is termed PCL (plasma cell leukemia). Although arguments can be made regarding that hard cut off.
"Plasmacytoid" is a term that is used by pathologists to describe the morphology (what the cells look like). It is more than likely a benign finding that is sometimes even be related to the processing of the slide prior to review. And in someone with myeloma the pathologist may over call it to bring to the attention of oncologist. Reactive lymphocytes can have that appearance (infections or other active process). Even myeloma cells (in the marrow)- especially t(11;14) myeloma- can look a little immature and have that appearance. Other lymphomas can also have that appearance (marginal zone, mantle cell, LPL). However, this not likely in your case. But it is something that I would bring to your multiple myeloma Drs attention, if not already.
In your case it is likely nothing at all.
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Dr. Ken Shain - Name: Ken Shain, M.D., Ph.D.
Beacon Medical Advisor
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