Skip to main content

Lymphoplasmacytic Lymphoma

  • Chapter
  • First Online:
Molecular Pathology of Hematolymphoid Diseases

Part of the book series: Molecular Pathology Library ((MPLB,volume 4))

  • 1279 Accesses

Abstract

Lymphoplasmacytic lymphoma (LPL), by definition, is a low-grade B cell lymphoma, which displays variable degrees of plasmacytic differentiation and is associated with a serum monoclonal protein, usually of IgM type, but may occasionally be of IgA or IgG type. The term LPL has been used interchangeably with Waldenstrom macroglobulinemia (WM), and yet a variety of low-grade B cell lymphomas, such as small lymphocytic lymphoma/chronic lymphocytic leukemia (CLL) and marginal zone B cell lymphoma (MZL), may also present with IgM macroglobulinemia. The current recommendation is that when the term WM is used clinically to designate a disease entity, it should be applied exclusively to patients with an underlying LPL.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 279.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Owen RG. Developing diagnostic criteria in Waldenstrom’s macroglobulinemia. Semin Oncol. 2003;30:196–200.

    Article  PubMed  Google Scholar 

  2. Waldenstrom J. Incipient myelomatosis or “essential” hyperglobulinemia with fibrinognenopenia: a new syndrome? Acta Med Scand. 1944;117:216–247.

    Article  Google Scholar 

  3. Lin P, Hao S, Handy BC, Bueso-Ramos CE, Medeiros LJ. Lymphoid neoplasms associated with IgM paraprotein: a study of 382 patients. Am J Clin Pathol. 2005;123:200–205.

    Article  PubMed  Google Scholar 

  4. A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin’s lymphoma. The Non-Hodgkin’s Lymphoma Classification Project, Blood. 1997;89:3909–3918.

    Google Scholar 

  5. Lin P, Bueso-Ramos C, Wilson CS, Mansoor A, Medeiros LJ. Waldenstrom macroglobulinemia involving extramedullary sites: morphologic and immunophenotypic findings in 44 patients. Am J Surg Pathol. 2003;27:1104–1113.

    Article  PubMed  Google Scholar 

  6. Konoplev S, Medeiros LJ, Bueso-Ramos CE, Jorgensen JL, Lin P. Immunophenotypic profile of lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia. Am J Clin Pathol. 2005;124:414–420.

    Article  PubMed  Google Scholar 

  7. Swerdlow SH, Berger F, Pileri SA. Lymphoplasmacytic lymphoma. In: Swerdlow SH, Campo E, Harris NL, et al., eds. World Health Organization Classification of Tumours of Hematopoietic and Lymphoid Tissues. Lyon, France: IARC Press; 2008:194–195.

    Google Scholar 

  8. Kristinsson SY, Bjorkholm M, Goldin LR, McMaster ML, Turesson I, Landgren O. Risk of lymphoproliferative disorders among first-degree relatives of lymphoplasmacytic lymphoma/Waldenstrom’s macroglobulinemia patients: a population-based study in Sweden. Blood. 2008;112(8):3052–3056.

    Article  CAS  PubMed  Google Scholar 

  9. Kristinsson SY, Koshiol J, Goldin LR, et al. Genetics- and immune-related factors in pathogenesis of lymphoplasmacytic lymphoma/Waldenstrom’s macroglobulinemia. Clin Lymphoma. 2009;9:23–26.

    Article  PubMed  Google Scholar 

  10. Treon SP, Hunter ZR, Aggarwal A, et al. Characterization of familial Waldenstrom’s macroglobulinemia. Ann Oncol. 2006;17:488–494.

    Article  CAS  PubMed  Google Scholar 

  11. Kyle RA, Therneau TM, Rajkumar SV, et al. A long-term study of prognosis in monoclonal gammopathy of undetermined significance. N Engl J Med. 2002;346:564–569.

    Article  PubMed  Google Scholar 

  12. Sahota SS, Forconi F, Ottensmeier CH, Stevenson FK. Origins of the malignant clone in typical Waldenstrom’s macroglobulinemia. Semin Oncol. 2003;30:136–141.

    Article  CAS  PubMed  Google Scholar 

  13. Sahota SS, Forconi F, Ottensmeier CH, et al. Typical Waldenstrom macroglobulinemia is derived from a B-cell arrested after cessation of somatic mutation but prior to isotype switch events. Blood. 2002;100:1505–1507.

    CAS  PubMed  Google Scholar 

  14. Walsh SH. Lymphoplasmacytic lymphoma/Waldenstrom’s macroglobulinemia derives from an extensively hypermutated B cell that lacks ongoing somatic hypermutation. Leuk Res. 2005;29:729–734.

    Article  CAS  PubMed  Google Scholar 

  15. Kriangkum J, Taylor BJ, Reiman T, Belch AR, Pilarski LM. Origins of Waldenstrom’s macroglobulinemia: does it arise from an unusual B-cell precursor? Clin Lymphoma. 2005;5:217–219.

    Article  PubMed  Google Scholar 

  16. Kriangkum J, Taylor BJ, Strachan E, et al. Impaired class switch recombination (CSR) in Waldenstrom macroglobulinemia (WM) despite apparently normal CSR machinery. Blood. 2006;107:2920–2927.

    Article  CAS  PubMed  Google Scholar 

  17. Kriangkum J, Taylor BJ, Treon SP, Mant MJ, Belch AR, Pilarski LM. Clonotypic IgM V/D/J sequence analysis in Waldenstrom macroglobulinemia suggests an unusual B-cell origin and an expansion of polyclonal B cells in peripheral blood. Blood. 2004;104:2134–2142.

    Article  CAS  PubMed  Google Scholar 

  18. Kriangkum J, Taylor BJ, Mant MJ, Treon SP, Belch AR, Pilarski LM. The malignant clone in Waldenstrom’s macroglobulinemia. Semin Oncol. 2003;30:132–135.

    Article  PubMed  Google Scholar 

  19. Kriangkum J, Taylor BJ, Treon SP, et al. Molecular characterization of Waldenstrom’s macroglobulinemia reveals frequent occurrence of two B-cell clones having distinct IGH VDJ sequences. Clin Cancer Res. 2007;13:2005–2013.

    Article  CAS  PubMed  Google Scholar 

  20. Martin-Jimenez P, Garcia-Sanz R, Sarasquete ME, et al. Functional class switch recombination may occur ‘in vivo’ in Waldenstrom macroglobulinaemia. Br J Haematol. 2007;136:114–116.

    Article  CAS  PubMed  Google Scholar 

  21. Admirand JH, Rassidakis GZ, Abruzzo LV, Valbuena JR, Jones D, Medeiros LJ. Immunohistochemical detection of ZAP–70 in 341 cases of non-Hodgkin and Hodgkin lymphoma. Mod Pathol. 2004;17:954–961.

    Article  CAS  PubMed  Google Scholar 

  22. San Miguel JF, Vidriales MB, Ocio E, et al. Immunophenotypic analysis of Waldenstrom’s macroglobulinemia. Semin Oncol. 2003;30:187–195.

    Article  CAS  PubMed  Google Scholar 

  23. Mansoor A, Medeiros LJ, Weber DM, et al. Cytogenetic findings in lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia. Chromosomal abnormalities are associated with the polymorphous subtype and an aggressive clinical course. Am J Clin Pathol. 2001;116:543–549.

    Article  CAS  PubMed  Google Scholar 

  24. Schop RFJ, Michael Kuehl W, Van Wier SA, et al. Waldenstrom macroglobulinemia neoplastic cells lack immunoglobulin heavy chain locus translocations but have frequent 6q deletions. Blood. 2002;100:2996–3001.

    Article  CAS  PubMed  Google Scholar 

  25. Schop RF, Jalal SM, Van Wier SA, et al. Deletions of 17p13.1 and 13q14 are uncommon in Waldenstrom macroglobulinemia clonal cells and mostly seen at the time of disease progression. Cancer Genet Cytogenet. 2002;132:55–60.

    Article  CAS  PubMed  Google Scholar 

  26. Ocio EM, Schop RF, Gonzalez B, et al. 6q deletion in Waldenstrom macroglobulinemia is associated with features of adverse prognosis. Br J Haematol. 2007;136:80–86.

    Article  CAS  PubMed  Google Scholar 

  27. Brggio E, Keats JJ, Leleu X, et al. High resolution genomic analysis in Waldenstrom’s macroglobulinemia identifies disease-specific and common abnormalities with marginal zone lymphomas. Clin Lymphoma. 2009;9:39–42.

    Article  CAS  PubMed  Google Scholar 

  28. Ackroyd S, O’Connor SJM, Owen RG. Rarity of IGH trans­locations in Waldenstrom macroglobulinemia. Cancer Genet Cytogenet. 2005;163:77–80.

    Article  CAS  PubMed  Google Scholar 

  29. Schop RF, Kuehl WM, Van Wier SA, et al. Waldenstrom macroglobulinemia neoplastic cells lack immunoglobulin heavy chain locus translocations but have frequent 6q deletions. Blood. 2002;100:2996–3001.

    Article  CAS  PubMed  Google Scholar 

  30. Cook JR, Aguilera NI, Reshmi-Skarja S, et al. Lack of PAX5 rearrangements in lymphoplasmacytic lymphomas: reassessing the reported association with t(9;14). Hum Pathol. 2004;35:447–454.

    Article  CAS  PubMed  Google Scholar 

  31. Andrieux J, Fert-Ferrer S, Copin MC, et al. Three new cases of non-Hodgkin lymphoma with t(9;14)(p13;q32). Cancer Genet Cytogenet. 2003;145:65–69.

    Article  CAS  PubMed  Google Scholar 

  32. Morrison AM, Jager U, Chott A, Schebesta M, Haas OA, Busslinger M. Deregulated PAX-5 transcription from a translocated IGH promoter in marginal zone lymphoma. Blood. 1998;92:3865–3878.

    CAS  PubMed  Google Scholar 

  33. Offit K, Parsa NZ, Filippa D, Jhanwar SC, Chaganti RS. t(9;14)(p13;q32) denotes a subset of low-grade non-Hodgkin’s lymphoma with plasmacytoid differentiation. Blood. 1992;80:2594–2599.

    CAS  PubMed  Google Scholar 

  34. Iida S, Rao PH, Ueda R, Chaganti RS, Dalla-Favera R. Chromosomal rearrangement of the PAX-5 locus in lymphoplasmacytic lymphoma with t(9;14)(p13;q32). Leuk Lymphoma. 1999;34:25–33.x`1

    CAS  PubMed  Google Scholar 

  35. Braggio E, Keats JJ, Leleu X, et al. Identification of copy number abnormalities and inactivating mutations in two negative regulators of nuclear factor-KB signalling pathways in Waldenstrom’s macroglobulinemia. Cancer Res. 2009;69:3579–3588.

    Article  PubMed  Google Scholar 

  36. McMaster ML, Goldin LR, Bai Y, et al. Genomewide linkage screen for Waldenstrom macroglobulinemia susceptibility loci in high-risk families. Am J Hum Genet. 2006;79:695–701.

    Article  CAS  PubMed  Google Scholar 

  37. Chng WJ, Schop RF, Price-Troska T, et al. Gene-expression profiling of Waldenstrom macroglobulinemia reveals a phenotype more similar to chronic lymphocytic leukemia than multiple myeloma. Blood. 2006;108:2755–2763.

    Article  CAS  PubMed  Google Scholar 

  38. Gutierrez NC, Ocio EM, de Las Rivas J, et al. Gene expression profiling of B lymphocytes and plasma cells from Waldenstrom’s macroglobulinemia: comparison with expression patterns of the same cell counterparts from chronic lymphocytic leukemia, multiple myeloma and normal individuals. Leukemia. 2007;21:541–549.

    Article  CAS  PubMed  Google Scholar 

  39. Hatjiharissi E, Zhan F, Adamia BT, et al. Gene expression profiling of Waldenstrom’s macroglobulinemia reveals genes that may be related to disease pathogenesis. Hematologica. 200; 92:92–93 (suppl 2).

    Google Scholar 

  40. Mitsiades CS, Mitsiades N, Treon SP, Anderson KC. Proteomic analyses in Waldenstrom’s macroglobulinemia and other plasma cell dyscrasias. Semin Oncol. 2003;30:156–160.

    Article  CAS  PubMed  Google Scholar 

  41. Baro C, Salido M, Domingo A, et al. Translocation t(9;14)(p13;q32) in cases of splenic marginal zone lymphoma. Haematologica. 2006;91:1289–1291.

    PubMed  Google Scholar 

  42. Tournilhac O. Excess bone marrow mast cells constitutively express CD154 (CD40 ligand) in Waldenstrom’s macroglobulinemia and may support tumor cell growth through CD154/CD40 pathway. J Clin Oncol. 2004;22(14S):6555.

    Google Scholar 

  43. Hatjiharissi E, Ngo H, Leontovich AA, et al. Proteomic analysis of Waldenstrom macroglobulinemia. Cancer Res. 2007;67:3777–3784.

    Article  CAS  PubMed  Google Scholar 

  44. Kostenko O, Tsacoumangos A, Crooks D, Kil SJ, Carlin C. Gab1 signaling is regulated by EGF receptor sorting in early endosomes. Oncogene. 2006;25:6604–6617.

    Article  CAS  PubMed  Google Scholar 

  45. Mitsiades N, Mitsiades CS, Richardson PG, et al. Molecular sequelae of histone deacetylase inhibition in human malignant B cells. Blood. 2003;101:4055–4062.

    Article  CAS  PubMed  Google Scholar 

  46. Leleu X, Jia X, Runnels J, et al. The Akt pathway regulates survival and homing in Waldenstrom macroglobulinemia. Blood. 2007;110:4417–4426.

    Article  CAS  PubMed  Google Scholar 

  47. Leleu X, Roccaro AM, Moreau AS, et al. Waldenstrom macroglobulinemia. Cancer Lett. 2008;270(1):95–107.

    Article  CAS  PubMed  Google Scholar 

  48. Burwick N, Roccaro AM, Leleu X, Ghobrial IM. Targeted therapies in Waldenstrom macroglobulinemia. Curr Opin Investig Drugs. 2008;9:631–637.

    CAS  PubMed  Google Scholar 

  49. Roccaro AM, Leleu X, Sacco A, et al. Dual targeting of the proteasome regulates survival and homing in Waldenstrom macroglobulinemia. Blood. 2008;111:4752–4763.

    Article  CAS  PubMed  Google Scholar 

  50. Moreau AS, Jia X, Patterson CJ, et al. The HMG-CoA inhibitor, simvastatin, triggers in vitro anti-tumour effect and decreases IgM secretion in Waldenstrom macroglobulinaemia. Br J Haematol. 2008;142:775–785.

    Article  CAS  PubMed  Google Scholar 

  51. Moreau AS, Jia X, Ngo HT, et al. Protein kinase C inhibitor enzastaurin induces in vitro and in vivo antitumor activity in Waldenstrom macroglobulinemia. Blood. 2007;109:4964–4972.

    Article  CAS  PubMed  Google Scholar 

  52. Chang H, Samiee S, Li D, Patterson B, Chen CI, Stewart AK. Analysis of IGH translocations, chromosome 13q14 and 17p13.1(p53) deletions by fluorescence in situ hybridization in Waldenstrom’s macroglobulinemia: a single center study of 22 cases. Leukemia. 2004;18:1160–1162.

    Article  CAS  PubMed  Google Scholar 

  53. Avet-Loiseau H, Garand R, Lode L, Robillard N, Bataille R. 14q32 Translocations discriminate IgM multiple myeloma from Waldenstrom’s macroglobulinemia. Semin Oncol. 2003;30:153–155.

    Article  CAS  PubMed  Google Scholar 

  54. Valdez R, Finn WG, Ross CW, Singleton TP, Tworek JA, Schnitzer B. Waldenstrom macroglobulinemia caused by extranodal marginal zone B-cell lymphoma: a report of six cases. Am J Clin Pathol. 2001;116:683–690.

    Article  CAS  PubMed  Google Scholar 

  55. Ye H, Chuang SS, Dogan A, Isaacson PG, Du MQ. t(1;14) and t(11;18) in the differential diagnosis of Waldenstrom’s macroglobulinemia. Mod Pathol. 2004;17:1150–1154.

    Article  PubMed  Google Scholar 

  56. Streubel B, Simonitsch-Klupp I, Mullauer L, et al. Variable frequencies of MALT lymphoma-associated genetic aberrations in MALT lymphomas of different sites. Leukemia. 2004;18:1722–1726.

    Article  CAS  PubMed  Google Scholar 

  57. Remstein ED, Kurtin PJ, Einerson RR, Paternoster SF, Dewald GW. Primary pulmonary MALT lymphomas show frequent and heterogeneous cytogenetic abnormalities, including aneuploidy and translocations involving API2 and MALT1 and IGH and MALT1. Leukemia. 2004;18:156–160.

    Article  CAS  PubMed  Google Scholar 

  58. Ye H, Dogan A, Karran L, et al. BCL10 expression in normal and neoplastic lymphoid tissue. Nuclear localization in MALT lymphoma. Am J Pathol. 2000;157:1147–1154.

    CAS  PubMed  Google Scholar 

  59. Merzianu M, Lin P, Medeiros L, et al. BCL-10 nuclear expression is present in a subset of lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia cases and correlates with extensive bone marrow disease. Mod Pathol. 2005;18(suppl 1):242A.

    Google Scholar 

  60. Pangalis GA, Kyrtsonis MC, Kontopidou FN, et al. Differential diagnosis of Waldenstrom’s macroglobulinemia and other B-cell disorders. Clinical Lymphoma. 2005;5:235–240.

    Article  PubMed  Google Scholar 

  61. Berger F, Traverse-Glehen A, Felman P, et al. Clinicopathologic features of Waldenstrom’s macroglobulinemia and marginal zone lymphoma: are they distinct or the same entity? Clin Lymphoma. 2005;5:220–224.

    Article  PubMed  Google Scholar 

  62. Ott MM, Rosenwald A, Katzenberger T, et al. Marginal zone B-cell lymphomas (MZBL) arising at different sites represent different biological entities. Genes Chromosomes Cancer. 2000;28:380–386.

    Article  CAS  PubMed  Google Scholar 

  63. Hernandez JM, Garcia JL, Gutierrez NC, et al. Novel genomic imbalances in B-cell splenic marginal zone lymphomas revealed by comparative genomic hybridization and cytogenetics. Am J Pathol. 2001;158:1843–1850.

    CAS  PubMed  Google Scholar 

  64. Berger F, Felman P, Thieblemont C, et al. Non-MALT marginal zone B-cell lymphomas: a description of clinical presentation and outcome in 124 patients. Blood. 2000;95:1950–1956.

    CAS  PubMed  Google Scholar 

  65. Papadaki T, Stamatopoulos K, Mavrommatis T, Anagnostopoulos A, Anagnostou D. A unique case of IgD-only splenic marginal-zone lymphoma with mutated immunoglobulin genes: ontogenetic implications. Leuk Res. 2008;32:155–157.

    Article  CAS  PubMed  Google Scholar 

  66. Papadaki T, Stamatopoulos K, Belessi C, et al. Splenic marginal-zone lymphoma: one or more entities? A histologic, immunohistochemical, and molecular study of 42 cases. Am J Surg Pathol. 2007;31:438–446.

    Article  PubMed  Google Scholar 

  67. Parrens M, Gachard N, Petit B, et al. Splenic marginal zone lymphomas and lymphoplasmacytic lymphomas originate from B-cell compartments with two different antigen-exposure histories. Leukemia. 2008;22:1621–1624.

    Article  CAS  PubMed  Google Scholar 

  68. Remstein ED, Hanson CA, Kyle RA, Hodnefield JM, Kurtin PJ. Despite apparent morphologic and immunophenotypic heterogeneity, Waldenstrom’s macroglobulinemia is consistently composed of cells along a morphologic continuum of small lymphocytes, plasmacytoid lymphocytes, and plasma cells. Semin Oncol. 2003;30:182–186.

    Article  PubMed  Google Scholar 

  69. Sargent RL, Cook JR, Aguilera NI, et al. Fluorescence immunophenotypic and interphase cytogenetic characterization of nodal lymphoplasmacytic lymphoma. Am J Surg Pathol. 2008;32:1643–1653.

    Article  PubMed  Google Scholar 

  70. Owen RG, Barrans SL, Richards SJ, et al. Waldenstrom macroglobulinemia. Development of diagnostic criteria and identification of prognostic factors. Am J Clin Pathol. 2001;116:420–428.

    Article  CAS  PubMed  Google Scholar 

  71. Kyrtsonis MC, Vassilakopoulos TP, Angelopoulou MK, et al. Waldenstrom’s macroglobulinemia: clinical course and prognostic factors in 60 patients. Experience from a single hematology unit. Ann Hematol. 2001;80:722–727.

    Article  CAS  PubMed  Google Scholar 

  72. Chubachi A, Ohtani H, Sakuyama M, et al. Diffuse large cell lymphoma occurring in a patient with Waldenstrom’s macroglobulinemia. Evidence for the two different clones in Richter’s syndrome. Cancer. 1991;68:781–785.

    Article  CAS  PubMed  Google Scholar 

  73. Sekikawa T, Takahara S, Suzuki H, Takeda N, Yamada H, Horiguchi-Yamada J. Diffuse large B-cell lymphoma arising independently to lymphoplasmacytic lymphoma: a case of two lymphomas. Eur J Haematol. 2007;78:264–269.

    Article  PubMed  Google Scholar 

  74. Rosales CM, Lin P, Mansoor A, Bueso-Ramos C, Medeiros LJ. Lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia associated with Hodgkin disease. A report of two cases. Am J Clin Pathol. 2001;116:34–40.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Lin, P. (2010). Lymphoplasmacytic Lymphoma. In: Dunphy, C. (eds) Molecular Pathology of Hematolymphoid Diseases. Molecular Pathology Library, vol 4. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-5698-9_18

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-5698-9_18

  • Published:

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4419-5697-2

  • Online ISBN: 978-1-4419-5698-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics