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974) Which of the following is NOT characteristic of lymphoplasmacytic lymphoma (LPL)?

A mixture of small lymphocytes, plasmacytoid lymphocytes, and plasma cells. CD5 negative, CD10 negative, and cytoplasmic IgM positive phenotype Hyperviscosity CD19 positive, CD20 positive/negative, CD5 positive, CD23 positive, and IgM and IgD positive phenotype Increased mast cells in the bone marrow.

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• The immunophenotype of CD19 positive, CD20 positive/negative, CD5 positive, CD23 positive, IgM positive, and IgD positive is characteristic for CLL/SLL, not lymphoplasmacytic lymphoma (LPL) (D). All other features are characteristic or can be seen in LPL.

• A mixture of small lymphocytes, plasmacytoid lymphocytes, and plasma cells is characteristic (A), but not specific, because other low-grade B-cell lymphomas can present with plasma cell differentiation, especially marginal zone lymphoma.

• The CD5 negative, CD10 negative, and cytoplasmic IgM positive phenotype is typical for LPL (B).

• The most common heavy chain isotype expressed and secreted by LPL is IgM. Hyperviscosity occurs in up to 30% of LPL patients (C) and the syndrome defined by hypervicosity is known as Waldenstrӧm macroglobulinemia.

• Admixture of increased mast cells is often seen in the bone marrow of LPL patients (E).

Swerdlow SH, Campo E, Harris NL, et al: WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues.Lyon, France: IARC, 2008.

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Anatomic Pathology: Hematopathology

974) Which of the following is NOT characteristic of lymphoplasmacytic lymphoma (LPL)?

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