Document 1191
 DOCN  M94A1191
 TI    Plasmacytosis in cytologic bone-marrow examination in patients with
       HIV-infection.
 DT    9412
 AU    Sandor P; Jung C; Bogner JR; Goebel FD; Medizinische Poliklinik,
       University of Munich School of Medicine,; Germany.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):188 (abstract no. PB0765). Unique
       Identifier : AIDSLINE ICA10/94371384
 AB    BACKGROUND: Bone-marrow aspirates in patients (pts.) with HIV-infection
       often reveal nonspecific reactive enhancement of the plasma cell
       population. The objective of our study is to evaluate quantitative and
       qualitative changes in the characteristics of the plasma cell
       population. METHODS: We reviewed all bone-marrow aspirates performed in
       out-patient department in pts. with HIV-infection since July 1990. A
       cell count was performed for each microscopic slide. Subsequently the
       plasma cell population was evaluated for qualitative changes by two
       cytologists; according to an increasing degree of qualitative changes,
       the plasma cells were qualified as normal, atypical or dysplastic. The
       serum gamma-globulin fraction in each patient was compared with the
       plasma cell count (pcc). RESULTS: In 35 pts. a bone-marrow aspiration
       was performed (Indications: pancytopenia in 9 pts., thrombocytopenia in
       6, anemia in 3, staging for lymphoma in 9 and microbiological purposes
       in 8). 16 pts. (46%) had a normal pcc, 19 pts. (54%) an increased one.
       The pcc did not correlate with the serum gamma-globulin level (see
       figure, correlation coefficient 0,31). In the group with normal pcc (<
       or = 3% plasma cells in the bone-marrow), 6 of 16 pts. (37%) had
       elevated gamma-globulines. In the group with high pcc (> 3% plasma
       cells) 9 of 19 pts. (47%) had this change; patients with very high
       gamma-globulin levels (> 40%) were all in this group. In the group with
       low pcc the qualitative results were: 10 normal, 5 atypical and 1
       dysplastic; in the group with high pcc: 1 normal, 9 atypical and 9
       dysplastic. The dysplastic specimens where often accompanied by high
       gamma-globulin levels, but in no case monoclonal gammopathy was
       detected. Morphologic criteria suggesting the cytologic diagnosis of
       plasmacytoma (pcc > or = 15%, atypical or dysplastic pattern, cluster
       formation) were fulfilled in two cases. CONCLUSION: Reactive
       plasmacytosis is a frequent finding in pts. with HIV-infection and
       cannot be predicted by the serum gamma-globulin levels. Plasma cell
       dysplasia may reach significant amounts, mimiking sometimes even
       plasmacytoma. The morphologic and numeric changes found in these
       patients are unusual in other reactive or inflammatory states. TABULAR
       DATA, SEE ABSTRACT VOLUME.
 DE    Anemia/BLOOD/COMPLICATIONS  Biological Markers/BLOOD  Biopsy, Needle
       Bone Marrow/*PATHOLOGY  Gamma Globulins/ANALYSIS  Hematologic
       Diseases/BLOOD/*COMPLICATIONS/PATHOLOGY  Human  HIV
       Infections/*BLOOD/*PATHOLOGY  Plasma Cells/*PATHOLOGY
       Thrombocytopenia/BLOOD/COMPLICATIONS  MEETING ABSTRACT

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