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:<span style="color:navy">'''Summary'''</span>
:<span style="color:navy">'''Summary'''</span>


:mu is the heavy chain element of IgM, and may be detected in the cytoplasm of early B cells. Membrane mu is present on mature B cells but following antigen encounter mu is generally replaced by other heavy chain types. Mu expression is used in the immunophenotypic sub-classification of ALL since cytoplasmic mu is acquired by pre-B cells then expressed on the cell surface of mature B-ALL (Burkitt lymphoma) together with surface light chain. Detection of either surface mu or light chain can therefore contribute to the identification of Bukitt lymphoma. The detection of cytoplasmic mu has value in the identification of pre-B ALL subtypes but can be done on bone marow trephine immunostaining.
:CD138 is a marker used to identify normal or malignant plasma cells with a high level of specificity, but does not discriminate normal from abnormal plasma cells and in some cases expression in myeloma may be low compared with normal plasma cells so sensitivity can be an issue. Abberancy of expression is low, but expression may be seen in lymphoplamacytic or marginal zone lymphomas (only on those cells that have plasma cell differentiation)


</div>
<span style="color:navy">'''Normal expression and function'''</span>
CD138 is a membrane protein that supports cell adhesion or binds cytokines and chemokines. In the hematopoietic system expression of CD138 is acquired by B lymphocytes as they develop into plasma cells.
<span style="color:navy">'''Diagnostic role'''</span>
*Most often CD138 used in conjunction with CD38 to identify plasma cells in the diagnosis or monitoring of myeloma
*There is very little aberrant expression, but neoplastic plasma cells may in some cases have weak, variable, or occasionally undetectable expression
*Expression is also seen cells that have plasmacytic differentiation in lymphoplasmacytoid lymphoma or marginal zone lymphoma 
<span style="color:navy">'''Other useful information'''</span>
Outside of haematopoiesis CD138 is expressed by squamous epithelium.
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<span style="color:navy">'''''SUMMARY TABLES'''''</span>


</div>


{| class=wikitable style="text-align: center; font-size:80%; width: 87.5%; height 20px;"
|-
!colspan="7"|<span style="font-size:100%">'''Expression: primitive cell types'''  ''Click (i) on table for additional information'' </span></font>
|-
! AML !! B ALL !! Burkitt || T ALL !! ETP ALL ('''[[Early T Precursor ALL (ETP-ALL)|i]]''') !! MPAL ('''[[Mixed Phenotype Acute Leukaemia (MPAL)|i]]) || H.gones ('''[[Haematogones|i]]''')
|-
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|-
|}


:<span style="color:navy">'''Background'''</span>


Mu heavy chain together with kappa or lambda light chains forms the IgM immunoglobulin molecule. In mature b-cells that have not encountered IgM is the predominant immunoglobulin type that forms part of the B-cell receptor (BCR). During B cell development the immunoglobulin heavy chain mu appears first in the cytoplasm where it is associated with surrogate light chains (pre-b cell stage) then subsequently is expressed on the membrane combined with either kappa or lambda light chain in mature B cells. Following antigen encounter IgM is most frequently replaced by other heavy chain forms. 


{| class=wikitable style="text-align: center; font-size:80%; width: 100%; height 20px;"
|-
!colspan="8"|'''Expression: mature B cell neoplasms'''
|-
! CLL !! MCL !!FL!! MZL !! HCL !! DLBCL || LPL !! PCL
|-
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #66e0ff; color:black"|5-20%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #66e0ff; color:black"|5-20%
|style="width: 14.25%; background: #006699; color:white"|40-80%
|style="width: 12.5%; background: #004466; color:white"|80-100%
|-
|}


:<span style="color:navy">'''Diagnostic Use'''</span>
<span style="font-size:90%">'''Notes:''' expression is usual in myeloma, and will occur on cells with plasma cell differentiation in LPL or MZL</span>


The changing expression of the mu heavy chain has value in the classification of B-lineage ALL
*cytoplasmic mu distinguishes pre-B ALL (mu expressed) from the more common early pre-B ALL (mu not expressed)
*surface expression of mu is a feature of mature forms of ALL including Burkitt lymphoma (where surface light chains will also be detected) 
*In histopathology mu expression is used to establish B cell lymphoma type, particularly lymphoplasmacytoid lymphoma where strong cytoplasmic expression is expected.




{| class=wikitable style="text-align: center; font-size:80%; width: 62.4%; height 40px;"
|-
!colspan="7"|'''Expression: mature T cell neoplasms'''
|-
! ATLL !! CTCL Sezary !! T-PLL !! T-LGL !! NK-LGL
|-
|style= "width: 20%; background: #FFE4E1; color:black"|limited
|style="width: 20%; background: #FFE4E1; color:black"|limited
|style="width: 20%; background: #FFE4E1; color:black"|limited
|style= "width: 20%; background: #FFE4E1; color:black"|limited
|style="width: 20%; background: #FFE4E1; color:black"|limited
|-
|}


-----
<span style="font-size:90%">'''Notes:''' limited reports are consistent with expression being very uncommon in T-lymphoproliferative disorders</span>
----

Latest revision as of 20:53, 13 June 2023


Summary
CD138 is a marker used to identify normal or malignant plasma cells with a high level of specificity, but does not discriminate normal from abnormal plasma cells and in some cases expression in myeloma may be low compared with normal plasma cells so sensitivity can be an issue. Abberancy of expression is low, but expression may be seen in lymphoplamacytic or marginal zone lymphomas (only on those cells that have plasma cell differentiation)



Normal expression and function

CD138 is a membrane protein that supports cell adhesion or binds cytokines and chemokines. In the hematopoietic system expression of CD138 is acquired by B lymphocytes as they develop into plasma cells.



Diagnostic role

  • Most often CD138 used in conjunction with CD38 to identify plasma cells in the diagnosis or monitoring of myeloma
  • There is very little aberrant expression, but neoplastic plasma cells may in some cases have weak, variable, or occasionally undetectable expression
  • Expression is also seen cells that have plasmacytic differentiation in lymphoplasmacytoid lymphoma or marginal zone lymphoma


Other useful information

Outside of haematopoiesis CD138 is expressed by squamous epithelium.


SUMMARY TABLES


Expression: primitive cell types Click (i) on table for additional information
AML B ALL Burkitt T ALL ETP ALL (i) MPAL (i) H.gones (i)
<5% <5% <5% <5% <5% <5% <5%


Expression: mature B cell neoplasms
CLL MCL FL MZL HCL DLBCL LPL PCL
<5% <5% <5% 5-20% <5% 5-20% 40-80% 80-100%

Notes: expression is usual in myeloma, and will occur on cells with plasma cell differentiation in LPL or MZL


Expression: mature T cell neoplasms
ATLL CTCL Sezary T-PLL T-LGL NK-LGL
limited limited limited limited limited

Notes: limited reports are consistent with expression being very uncommon in T-lymphoproliferative disorders