HAEM5:Lymphoplasmacytic lymphoma: Difference between revisions

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{{DISPLAYTITLE:Lymphoplasmacytic lymphoma}}
{{DISPLAYTITLE:Lymphoplasmacytic lymphoma}}
[[HAEM5:Table_of_Contents|Haematolymphoid Tumours (WHO Classification, 5th ed.)]]
[[HAEM5:Table_of_Contents|Haematolymphoid Tumours (WHO Classification, 5th ed.)]]


{{Under Construction}}
{{Under Construction}}


<blockquote class='blockedit'>{{Box-round|title=Content Update To WHO 5th Edition Classification Is In Process; Content Below is Based on WHO 4th Edition Classification|This page was converted to the new template on 2023-12-07. The original page can be found at [[HAEM4:Lymphoplasmacytic Lymphoma]].
<blockquote class="blockedit">{{Box-round|title=Content Update To WHO 5th Edition Classification Is In Process; Content Below is Based on WHO 4th Edition Classification|This page was converted to the new template on 2023-12-07. The original page can be found at [[HAEM4:Lymphoplasmacytic Lymphoma]].
Other relevent pages include: [[HAEM4:Waldenstrom Macroglobulinemia]]
Other relevent pages include: [[HAEM4:Waldenstrom Macroglobulinemia]]


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==Definition / Description of Disease==
*Lymphoplasmacytic lymphoma (LPL) is a neoplasm of small B lymphocytes, plasmacytoid lymphocytes, and plasma cells, usually involving bone marrow and spleen, which does not fulfil the criteria for any of the other small B-cell lymphoid neoplasms, that can have plasmacytic differentiation. <ref name=":0" />
*Based on the presence of the bone marrow involvement and the presence of paraprotein, LPL is categorized into [[HAEM5:Lymphoplasmacytic lymphoma|Waldenström macroglobulinemia]]  and LPL of non-Waldenström macroglobulinemia. <ref name=":1">{{Cite journal|last=Wang|first=Wei|last2=Lin|first2=Pei|date=2020-01|title=Lymphoplasmacytic lymphoma and Waldenström macroglobulinaemia: clinicopathological features and differential diagnosis|url=https://pubmed.ncbi.nlm.nih.gov/31767130|journal=Pathology|volume=52|issue=1|pages=6–14|doi=10.1016/j.pathol.2019.09.009|issn=1465-3931|pmid=31767130}}</ref>
*The majority of cases of LPL lymphoma are associated with IgM paraprotein secretion (Waldenström macroglobulinemia), with less than 5% of cases attributed to IgA, IgG, and nonsecreting cases of LPL. <ref>{{Cite journal|last=Hunter|first=Zachary R.|last2=Yang|first2=Guang|last3=Xu|first3=Lian|last4=Liu|first4=Xia|last5=Castillo|first5=Jorge J.|last6=Treon|first6=Steven P.|date=2017-03-20|title=Genomics, Signaling, and Treatment of Waldenström Macroglobulinemia|url=https://pubmed.ncbi.nlm.nih.gov/28294689|journal=Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology|volume=35|issue=9|pages=994–1001|doi=10.1200/JCO.2016.71.0814|issn=1527-7755|pmid=28294689}}</ref>
==Synonyms / Terminology==
Malignant lymphoma, lymphoplasmacytoid lymphoma.<ref name=":0" />
==Epidemiology / Prevalence==
*Lymphoplasmacytic lymphoma, in approximately 95% of cases, occurs in patients of Caucasian descent. <ref name=":1" />
*The median age is in the seventh decade of life. <ref name=":0" /><ref name=":1" />
*Approximately 1000-1500 new cases are diagnosed yearly in the United States.
*LPL associated with IgM ([[HAEM5:Lymphoplasmacytic lymphoma|Waldenström macroglobulinemia]]) is more commonly occurs in male patients, while LPL  with a non-IgM is reported more frequently in females. <ref name=":2" />
==Clinical Features==
{| class="wikitable"
|'''Signs and Symptoms'''
|Weakness (usually related to anemia)
Fatigue
Hyperviscosity (in 30% of cases)
Lymphadenopathy and splenomegaly (in 10-20% of patient at time of diagnosis)
Paraprotein deposition in tissues with organ-specific dysfunction:
*Neuropathy (minority of patients; may be related to the IgM paraprotein with myelin sheath antigens)
*Diarrhea (rare, due to paraprotein deposition in gastrointestinal tract)
*Coagulopathy (may be cause by IgM binding to clotting factors)
*Bullae or papules in the skin
*Proteinuria and renal failure
|-
|'''Laboratory Findings'''
|IgM paraprotein
IgM and IgG paraprotein (minority of patients)
Cold agglutinins
Cryoglobulinemia
|}
<blockquote class='blockedit'>{{Box-round|title=Unassigned References|The following referenees were placed in the header. Please place them into the appropriate locations in the text.}}</blockquote><ref name=":0" /><ref name=":1" /><blockquote class="blockedit">
<center><span style="color:Maroon">'''End of V4 Section'''</span>
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</blockquote>
==Sites of Involvement==
*Bone marrow (most of cases), lymph nodes, spleen, liver, and other extranodal sites. The peripheral blood may also be involved.
*Rare involvement of CNS associated with Waldenström macroglobulinemia (known as [[Bing-Neel syndrome]]). Lymphoplasmacytic lymphoma may occur at sites typically involved by extranodal marginal zone lymphoma (MZL) of mucosal-associated lymphoid tissue (MALT lymphoma), such as the ocular adnexa. <ref name=":0" /><ref name=":1" />
*Patients with non-IgM LPL are more likely to present with extramedullary involvement such as lymphadenopathy, splenomegaly, or extranodal disease. <ref name=":2" />
*Bone marrow involvement is more common in patients with IgM-associated LPL ([[HAEM5:Lymphoplasmacytic lymphoma|Waldenström macroglobulinemia]]) when compared to non-IgM LPL. <ref name=":2" />
==Morphologic Features==
*Bone marrow involvement is characterized by diffuse, interstitial, and nodular infiltration patterns. Paratrabecular can also be  present; however, it has  been observed more frequently in cases of [[marginal zone lymphoma.]]
*The infiltrate is characterized by small monotonous lymphocytes admixed with a variable amount of plasmacytoid lymphocytes and plasma cells. Although nonspecific, variable amount of reactive mast cell and hemosiderin deposits are frequently observed. Dutcher bodies (nuclear vacuoles containing IgM protein) and Russell bodies (cytoplasmic inclusion) are often seen similarly in multiple myeloma cases. <ref name=":0" />
*Peripheral blood often demonstrates lymphoma cells with similar morphology. Leukocytosis is not typically observed. Peripheral blood may also demonstrate a rouleaux formation due to increased IgM paraprotein.
==Immunophenotype==
Put your text here and fill in the table
{| class="wikitable sortable"
|-
!Finding!!Marker
|-
|Positive (subset)
|IgM
|-
|Positive (subset)
|IgG
|-
|Positive (subset)
|IgA
|-
|Positive (universal)||CD19
|-
|Positive (universal)||CD20
|-
|Positive (universal)||CD22 (dim)
|-
|Positive (universal)||CD25
|-
|Positive (universal)
|CD79a
|-
|Positive (universal)
|CD45
|-
|Positive (variable)
|CD38
|-
|Positive (universal)
|PAX5
|-
|Positive (subset)
|CD5
|-
|Positive (subset)
|CD10
|-
|Positive (subset)
|TCL1
|-
|Negative (universal)
|Cyclin D1
|-
|Negative (universal)
|LEF1
|-
|Negative (universal)
|EBV stain
|-
|Negative (universal)
|CD56
|-
|Negative (universal)
|CD117
|}
<blockquote class='blockedit'>{{Box-round|title=Unassigned References|The following referenees were placed in the header. Please place them into the appropriate locations in the text.}}</blockquote><ref name=":1" /><blockquote class="blockedit">
<center><span style="color:Maroon">'''End of V4 Section'''</span>
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</blockquote>
==WHO Essential and Desirable Genetic Diagnostic Criteria==
==WHO Essential and Desirable Genetic Diagnostic Criteria==
<span style="color:#0070C0">(''Instructions: The table will have the diagnostic criteria from the WHO book <u>autocompleted</u>; remove any <u>non</u>-genetics related criteria. If applicable, add text about other classification'' ''systems that define this entity and specify how the genetics-related criteria differ.'')</span>
<span style="color:#0070C0">(''Instructions: The table will have the diagnostic criteria from the WHO book <u>autocompleted</u>; remove any <u>non</u>-genetics related criteria. If applicable, add text about other classification'' ''systems that define this entity and specify how the genetics-related criteria differ.'')</span>
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<blockquote class='blockedit'>{{Box-round|title=Unassigned References|The following referenees were placed in the header. Please place them into the appropriate locations in the text.}}</blockquote><ref name=":0" /><ref name=":1" /><blockquote class="blockedit">
<blockquote class="blockedit">{{Box-round|title=Unassigned References|The following referenees were placed in the header. Please place them into the appropriate locations in the text.}}</blockquote><ref name=":0" /><ref name=":1">{{Cite journal|last=Wang|first=Wei|last2=Lin|first2=Pei|date=2020-01|title=Lymphoplasmacytic lymphoma and Waldenström macroglobulinaemia: clinicopathological features and differential diagnosis|url=https://pubmed.ncbi.nlm.nih.gov/31767130|journal=Pathology|volume=52|issue=1|pages=6–14|doi=10.1016/j.pathol.2019.09.009|issn=1465-3931|pmid=31767130}}</ref><blockquote class="blockedit">
<center><span style="color:Maroon">'''End of V4 Section'''</span>
<center><span style="color:Maroon">'''End of V4 Section'''</span>
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<nowiki>*</nowiki>''Citation of this Page'': “Lymphoplasmacytic lymphoma”. Compendium of Cancer Genome Aberrations (CCGA), Cancer Genomics Consortium (CGC), updated {{REVISIONMONTH}}/{{REVISIONDAY}}/{{REVISIONYEAR}}, <nowiki>https://ccga.io/index.php/HAEM5:Lymphoplasmacytic_lymphoma</nowiki>.
<nowiki>*</nowiki>''Citation of this Page'': “Lymphoplasmacytic lymphoma”. Compendium of Cancer Genome Aberrations (CCGA), Cancer Genomics Consortium (CGC), updated {{REVISIONMONTH}}/{{REVISIONDAY}}/{{REVISIONYEAR}}, <nowiki>https://ccga.io/index.php/HAEM5:Lymphoplasmacytic_lymphoma</nowiki>.
[[Category:HAEM5]][[Category:DISEASE]][[Category:Diseases L]]
[[Category:HAEM5]]
[[Category:DISEASE]]
[[Category:Diseases L]]

Revision as of 11:57, 11 February 2025


Haematolymphoid Tumours (WHO Classification, 5th ed.)

editContent Update To WHO 5th Edition Classification Is In Process; Content Below is Based on WHO 4th Edition Classification
This page was converted to the new template on 2023-12-07. The original page can be found at HAEM4:Lymphoplasmacytic Lymphoma.

Other relevent pages include: HAEM4:Waldenstrom Macroglobulinemia

Note: author needs to coorelate with Waldenstrom Macroglobulinemia

(General Instructions – The focus of these pages is the clinically significant genetic alterations in each disease type. This is based on up-to-date knowledge from multiple resources such as PubMed and the WHO classification books. The CCGA is meant to be a supplemental resource to the WHO classification books; the CCGA captures in a continually updated wiki-stye manner the current genetics/genomics knowledge of each disease, which evolves more rapidly than books can be revised and published. If the same disease is described in multiple WHO classification books, the genetics-related information for that disease will be consolidated into a single main page that has this template (other pages would only contain a link to this main page). Use HUGO-approved gene names and symbols (italicized when appropriate), HGVS-based nomenclature for variants, as well as generic names of drugs and testing platforms or assays if applicable. Please complete tables whenever possible and do not delete them (add N/A if not applicable in the table and delete the examples); to add (or move) a row or column in a table, click nearby within the table and select the > symbol that appears. Please do not delete or alter the section headings. The use of bullet points alongside short blocks of text rather than only large paragraphs is encouraged. Additional instructions below in italicized blue text should not be included in the final page content. Please also see Author_Instructions and FAQs as well as contact your Associate Editor or Technical Support.)

Primary Author(s)*

Kapitolina Semenova, MD, Jack Reid, MD, Fabiola Quintero-Rivera, MD

Departments of Pathology, Laboratory Medicine, and *Pediatrics, Division of Genetic and Genomic Medicine, University of California, Irvine (UCI)

WHO Classification of Disease

Structure Disease
Book Haematolymphoid Tumours (5th ed.)
Category B-cell lymphoid proliferations and lymphomas
Family Mature B-cell neoplasms
Type N/A
Subtype(s) Lymphoplasmacytic lymphoma

WHO Essential and Desirable Genetic Diagnostic Criteria

(Instructions: The table will have the diagnostic criteria from the WHO book autocompleted; remove any non-genetics related criteria. If applicable, add text about other classification systems that define this entity and specify how the genetics-related criteria differ.)

WHO Essential Criteria (Genetics)*
WHO Desirable Criteria (Genetics)*
Other Classification

*Note: These are only the genetic/genomic criteria. Additional diagnostic criteria can be found in the WHO Classification of Tumours.

Related Terminology

(Instructions: The table will have the related terminology from the WHO autocompleted.)

Acceptable
Not Recommended

Gene Rearrangements

No specific chromosomal abnormalities are identified in LPL.

Chromosomal Rearrangement Genes in Fusion (5’ or 3’ Segments) Pathogenic Derivative Prevalence Diagnostic Significance (Yes, No or Unknown) Prognostic Significance (Yes, No or Unknown) Therapeutic Significance (Yes, No or Unknown) Notes
t(9:14)(p13:q32) IGH/PAX5 rare Yes No No


editUnassigned References
The following referenees were placed in the header. Please place them into the appropriate locations in the text.

[1][2]

End of V4 Section

Individual Region Genomic Gain/Loss/LOH

Chr # Gain / Loss / Amp / LOH Minimal Region Genomic Coordinates [Genome Build] Minimal Region Cytoband Diagnostic Significance (Yes, No or Unknown) Prognostic Significance (Yes, No or Unknown) Therapeutic Significance (Yes, No or Unknown) Notes
EXAMPLE:

Characteristic Chromosomal or Other Global Mutational Patterns

Put your text here

Chromosomal Pattern Diagnostic Significance (Yes, No or Unknown) Prognostic Significance (Yes, No or Unknown) Therapeutic Significance (Yes, No or Unknown) Notes
EXAMPLE:


Gene Mutations (SNV/INDEL)


Gene; Genetic Alteration Presumed Mechanism (Tumor Suppressor Gene [TSG] / Oncogene / Other) Prevalence (COSMIC / TCGA / Other) Concomitant Mutations Mutually Exclusive Mutations Diagnostic Significance (Yes, No or Unknown) Prognostic Significance (Yes, No or Unknown) Therapeutic Significance (Yes, No or Unknown) Notes
MYD88 L265; Activating mutation >90% Yes Yes Yes This is also seen in some non-germinal centre subtype DLBCL, NOS, primary cutaneous DLBCL, leg type, and primary CNS and testicular DLBCL cases.


Cases lacking MYDBB L265P mutation are reported to have an adverse prognosis and a lower response to ibrutinib.

CXCR4 S338X or or frameshift mutations 30% Yes Yes Cases with nonsense mutations, has been associated with more symptomatic/active disease, other clinical and laboratory findings, and greater resistance to ibrutinib and possibly other therapeutic agents.


Mutations are similar to those seen in the syndrome of warts, hypogammaglobulinaemia, immunodeficiency, and myelokathexis (WHIM syndrome).


Mutations in this gene are also present in a very small proportion of other small B-cell lymphomas.

ARID1A 17%

Less commonly, other somatic mutations, such as mutations of TP53, CD79B, KMT20 (previously designated MLL2), and MYBBP1A


Note: A more extensive list of mutations can be found in cBioportal (https://www.cbioportal.org/), COSMIC (https://cancer.sanger.ac.uk/cosmic), ICGC (https://dcc.icgc.org/) and/or other databases. When applicable, gene-specific pages within the CCGA site directly link to pertinent external content.

Epigenomic Alterations

Put your text here

Genes and Main Pathways Involved

Put your text here and fill in the table

Gene; Genetic Alteration Pathway Pathophysiologic Outcome
EXAMPLE: BRAF and MAP2K1; Activating mutations EXAMPLE: MAPK signaling EXAMPLE: Increased cell growth and proliferation
EXAMPLE: CDKN2A; Inactivating mutations EXAMPLE: Cell cycle regulation EXAMPLE: Unregulated cell division
EXAMPLE: KMT2C and ARID1A; Inactivating mutations EXAMPLE: Histone modification, chromatin remodeling EXAMPLE: Abnormal gene expression program

Genetic Diagnostic Testing Methods

Put your text here (Instructions: Include recommended testing type(s) to identify the clinically significant genetic alterations.)

Familial Forms

Put your text here (Instructions: Include associated hereditary conditions/syndromes that cause this entity or are caused by this entity.)

Additional Information

Put your text here

Links

Put a link here or anywhere appropriate in this page (Instructions: Highlight the text to which you want to add a link in this section or elsewhere, select the "Link" icon at the top of the wiki page, and search the name of the internal page to which you want to link this text, or enter an external internet address by including the "http://www." portion.)

References

  1. Cite error: Invalid <ref> tag; no text was provided for refs named :0
  2. Wang, Wei; et al. (2020-01). "Lymphoplasmacytic lymphoma and Waldenström macroglobulinaemia: clinicopathological features and differential diagnosis". Pathology. 52 (1): 6–14. doi:10.1016/j.pathol.2019.09.009. ISSN 1465-3931. PMID 31767130. Check date values in: |date= (help)

(use "Cite" icon at top of page

Notes

*Primary authors will typically be those that initially create and complete the content of a page. If a subsequent user modifies the content and feels the effort put forth is of high enough significance to warrant listing in the authorship section, please contact the CCGA coordinators (contact information provided on the homepage). Additional global feedback or concerns are also welcome.


*Citation of this Page: “Lymphoplasmacytic lymphoma”. Compendium of Cancer Genome Aberrations (CCGA), Cancer Genomics Consortium (CGC), updated 02/11/2025, https://ccga.io/index.php/HAEM5:Lymphoplasmacytic_lymphoma.