Contributed by Sanja Dacic, MD, PhD.
Published on line in January 2000
CLINICAL HISTORY:
The patient is a 46-year-old HIV-positive man with a history of substance abuse who presented with a destructive palate lesion that eroded into nasal cavity and maxillary sinus.
MICROSCOPIC DESCRIPTION:
Histologic sections of the palate lesion demonstrate bone and fibrotic tissue with nests and sheets of intermediate sized cells (Image 01 and Image 02). Many of cells have dispersed chromatin, eccentric nuclei and small nucleoli (Image 03). Some of cells appear plasmacytic with occasional large, multinucleated cells seen ( Image 04). Many of the cells are undergoing apoptosis ( Image 05).
IMMUNOHISTOCHEMISTRY:
Antigen/Antibody | Usual Reactivity | Result |
---|---|---|
anti-kappa | B cell subset | Negative |
anti-lambda ( Image 06) |
B cell subset | Positive |
anti-IgG | B cell subset | Negative |
anti-IgA | B cell subset | Negative |
anti-IgM | B cell subset | Negative |
CD20/L26 | B cell | Negative |
J chain (Image 07) |
Plasma cell | Focally positive |
CD3 | T cell | Scattered positive lymphocytes |
CD4 | T cell subset | Neoplastic cells Negative |
CD57/Leu 7 | T subset/NK | Scattered positive cells |
CD45/LCA | Leukocytes | Scattered positive cells |
CD68/PGM-1 | Myeloid, macrophage, some lymphocytes | Moderate number of scattered positive cells |
CD138 (Images 08) |
Plasma cells | Positive |
EBV-ISH (EBERS) (Image 09) |
Plasma cells | Positive |
Pankeratin | Cytokeratin | Negative |
S100/S100a | Neural, melanoma & other | Negative |