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Great image. In CD23 negative cases, beware of the Small cell varriant of multiple myeloma. It also has the t(11:14) and stains positive (moderate, and varriable, like MCL) for cyclin D1. Unlike the translocation in MCL, this finding in myeloma is thought to portend a better prognosis.

----Comment by: Iago on 3/13/2008 9:54:33 AM

Excellent points. Are small cell myelomas CD5 positive, though?

----Comment by: PathDoc15 on 3/14/2008 7:15:51 AM

I dont think so however they must be CD38 and CD138 positive the lasted being more specific. Here is a good review article from England shrot and straight to the point : 1

----Comment by: savco on 3/14/2008 8:37:06 AM

...and of course CD56 is a great marker for myeloma across the board (vs. normal plasma cell)

----Comment by: PathDoc15 on 3/14/2008 12:35:30 PM

Don't forget about the potential pitfall of CD20 staining in the small cell variant of myeloma. Not every case with t(11;14) stains with CD20, but there is a positive association between CD20-positivity and the presence of t(11;14).

----Comment by: DrJ on 3/14/2008 6:22:37 PM


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