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Immunohistochemical analysis of CD 123, CD 56 and CD 4 for the diagnosis of minimal bone marrow involvement by blastic plasmacytoid dendritic cell neoplasm
Author(s) -
Hwang Keumrock,
Park ChanJeoung,
Jang Seongsoo,
Chi HyunSook,
Huh JooRyung,
Lee Je Hwan,
Suh Cheolwon,
Lee Kyoo Hyung
Publication year - 2013
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12079
Subject(s) - interleukin 3 receptor , immunohistochemistry , pathology , bone marrow , plasmacytoid dendritic cell , medicine , malignancy , myeloid , dendritic cell , antigen , immunology
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 CD 4, CD 56 and CD 123 was performed on BM biopsies or clot sections. IHC revealed minimal BM involvement ( CD 123, 3/3; CD 56, 2/3; CD 4, 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 CD 123, CD 56 and CD 4 in BPDCN patients, particularly in cases where the initial BM study indicates normal morphology.