Immunohistochemical analysis of CD 123, CD 56 and CD 4 for the diagnosis of minimal bone marrow involvement by blastic plasmacytoid dendritic cell neoplasm
K Hwang, CJ Park, S Jang, HS Chi, JR Huh… - …, 2013 - Wiley Online Library
K Hwang, CJ Park, S Jang, HS Chi, JR Huh, JH Lee, C Suh, KH Lee
Histopathology, 2013•Wiley Online LibraryAims Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive
haematological malignancy derived from plasmacytoid dendritic cell precursors. Almost all
patients show cutaneous manifestations, and> 60% show bone marrow (BM) involvement at
initial presentation. In cases where there is BM involvement by only a small number of
tumour cells, such involvement is difficult to ascertain solely on morphological examination.
In such situations, immunohistochemistry (IHC) may be useful in revealing minimal BM …
haematological malignancy derived from plasmacytoid dendritic cell precursors. Almost all
patients show cutaneous manifestations, and> 60% show bone marrow (BM) involvement at
initial presentation. In cases where there is BM involvement by only a small number of
tumour cells, such involvement is difficult to ascertain solely on morphological examination.
In such situations, immunohistochemistry (IHC) may be useful in revealing minimal BM …
Aims
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive haematological malignancy derived from plasmacytoid dendritic cell precursors. Almost all patients show cutaneous manifestations, and >60% show bone marrow (BM) involvement at initial presentation. In cases where there is BM involvement by only a small number of tumour cells, such involvement is difficult to ascertain solely on morphological examination. In such situations, immunohistochemistry (IHC) may be useful in revealing minimal BM involvement by BPDCN.
Methods and results
We investigated six patients with BPDCN. Initial morphological diagnosis disclosed BM involvement in only one of the six patients. To confirm BM involvement, IHC for CD4, CD56 and CD123 was performed on BM biopsies or clot sections. IHC revealed minimal BM involvement (CD123, 3/3; CD56, 2/3; CD4, 2/3) in three patients with BM that appeared morphologically normal.
Conclusions
Our data clearly support the utility of IHC in diagnosing minimal BM involvement by BPDCN. Accordingly, we highly recommend immunohistochemical analyses for CD123, CD56 and CD4 in BPDCN patients, particularly in cases where the initial BM study indicates normal morphology.
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