[Tim59]

Nucleolated plasma cells - what does that mean?

by Tim59 on Tue Jan 27, 2015 5:20 pm

On my biopsy report, it mentions nucleolated forms when describing the plasma cells.

What does that mean? Does that mean myeloma cells?

Thanks,
Tim

[Multibilly]

Re: Nucleolated plasma cells - what does that mean?

by Multibilly on Wed Jan 28, 2015 9:31 am

Tim,

What else does the report say and what does your doctor say?

A nucleolated plasma cell is simply a plasma cell with a nucleus. Usually, this section of the report will also talk about other visual characteristics of the plasma cells that were examined (abnormal shape, etc), which can signify if they are multiple myeloma cells.

Multiple myeloma cells also tend to have unique markers (clusters of differentiation, aka "CD") on them. This would be described in the section that talks about the various "CD" findings. Multiple myeloma cells will also pick up some of the special stains mentioned in the biopsy report.

Also, what was your overall plasma cell percentage?

BTW, you might consider registering for this site so that folks can see your earlier posts to better help you over time.

[Tim59]

Re: Nucleolated plasma cells - what does that mean?

by Tim59 on Fri Jan 30, 2015 2:23 pm

Thanks for the reply.

Normocellular marrow (50% fat) with aspiration artifact. Approximately 10% of the cellularity is comprised of an interstitial infiltrate of plasma cells, including dysplastic, nucleolated forms, occurring singly and in small clusters. Immunoperoxidase and in situ hybridization studies reveal monotypic cytoplasmic reactivity of the CD138 positive plasma cells for immunoglobulin kappa light chain. Scattered plasma cells exhibit cytoplasmic reactivity for immunoglobulin lambda light chain. Mast cells are seen.

Of the remaining cellularity:

Erythroid elements are mildly proportionally increased and exhibit maturation.
Myeloid elements are mildly proportionally decreased and exhibit maturation.
Blasts appear to comprise less than 5% of the marrow cellularity.
Megakaryocytes are present in normal numbers.
Scattered lymphocytes are seen (non-diagnostic).
Bone trabeculae exhibit focal osteoblastic activity.

Any help with what that means (interstitial infiltrate of plasma cells, including dysplastic, nucleolated forms)?

[Multibilly]

Re: Nucleolated plasma cells - what does that mean?

by Multibilly on Fri Jan 30, 2015 4:34 pm

First off, I'm not a doc, so please verify all this with one.

With myeloma, the plasma cells affected by the myeloma disease are misshapen. "Dysplastic, nucleloated cells" simply means misshapen cells that contain a nucleus (the roundish blob in the middle of a cell that contains its genetic material). Myeloma cells also tend to have eccentric (irregular) shaped nuclei.

You also show that the cells in your BMB are CD138+, which can be a sign that your plasma cells are affected by myeloma.. This simply means that you have some specific proteins on the surface of these cells that tend to be unique to myeloma cells.

There should be a summary statement in the biopsy report that will state that the BMB findings are consistent with "xyz" disease. I'm assuming you probably already have a diagnosis from your doctor if you are reading this report - your doc would be better able to explain these results than me. Again, please verify all this with your doc.

[Dr. Jason Valent]

Re: Nucleolated plasma cells - what does that mean?

by Dr. Jason Valent on Mon Feb 23, 2015 6:15 pm

The nucleolus is part of the nucleus where protein synthesis is starting to occur. Abnormal plasma cells often have a prominent nucleolus, which is why it is commented on in the report. Your report would suggest there are about 10% abnormal plasma cells present / remaining in the marrow.

If this is before treatment, it may not mean that treatment is necessary unless there are other criteria being met for symptomatic multiple myeloma, such as elevated calcium in the blood, kidney damage, low hemoglobin, or bone disease on imaging studies.

If this marrow is from after treatment, it suggests that a low level of abnormal cells (myeloma cells) are still present.

Hope this helps.