PMC8182221_01
Hematoxylin-eosin-stained slide of the subcortical hypocellular bone marrow showing
small non-paratrabecular aggregates and scattered interstitial cells (50x oil).
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Lymphoid aggregates were composed of CD20 positive B cells with admixed CD138 positive plasma cells with kappa predominance (Figures 1-6).
Immunohistochemistry for CD20 shows that the majority of the cells within the aggregate
and many within the interstitium are B cells (20x).
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Lymphoid aggregates were composed of CD20 positive B cells with admixed CD138 positive plasma cells with kappa predominance (Figures 1-6).
Conversely, CD3 immunohistochemistry shows only occasional scattered T cells (20x).
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Lymphoid aggregates were composed of CD20 positive B cells with admixed CD138 positive plasma cells with kappa predominance (Figures 1-6).
CD138 demonstrates increased numbers of plasma cells within the interstitium and the
aggregate.
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PMC8182221_01_10.1177_23247096211021228-fig4.jpg
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Lymphoid aggregates were composed of CD20 positive B cells with admixed CD138 positive plasma cells with kappa predominance (Figures 1-6).
The plasmacytoid lymphocytes and plasma cells are kappa restricted.
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Lymphoid aggregates were composed of CD20 positive B cells with admixed CD138 positive plasma cells with kappa predominance (Figures 1-6).
The histograms represent the gated lymphocytes. Of the gated lymphocytes, approximately
34% (red dots) are B cells that coexpress CD19 and CD20 and exhibit surface kappa light
chain restriction.
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Lymphoid aggregates were composed of CD20 positive B cells with admixed CD138 positive plasma cells with kappa predominance (Figures 1-6).
Magnetic resonance imaging of the brain showing intracranial white matter enhancements
consistent with disease progression (blue arrows).
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A repeat MRI was done that showed progression of white matter enhancement (Figure 7).
Magnetic resonance imaging of the brain 2 months after treatment with ibrutinib showing
complete resolution of previously noticed white matter enhancements.
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Repeat MRI brain after 2 months of ibrutinib showed complete resolution of intracranial enhancement (Figure 8).