An Immunohistologic Study of Multiple Myeloma and Related Conditions, Using an Immunoperoxidase Method

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Abstract
Taylor, Clive R., Russell, Raymond, and Chandor, Stebbins: An immunohistologic study of multiple myeloma and related conditions, using an immunoperoxidase method. Am J Clin Pathol 70: 612–622, 1978. This study illustrates both some of the uses and the limitations of the immunoperoxidase method, and emphasizes the broad range of immunochemical findings that may be seen in B-cell neoplasia. Paraffin-embedded sections of bone marrow from 29 cases of various types of monoclonal gammopathy were examined by an immunoperoxidase method that permits demonstration of cytoplasmic immunoglobulin and yet preserves cellular morphology. In each case serial sections were stained for the presence of light and heavy chains, and the resulting staining pattern was compared with the serum and urinary immunoglobulin findings. In IgG and IgA monoclonal gammopathies and in macroglobulinemia there was good correlation between the observed pattern of cytoplasmic staining and the serum–urine monoclonal protein type. Anomalous staining patterns, in which there was no clear correlation between serum–urine monoclonal protein type and the immunoperoxidase staining pattern, were encountered in cases of IgD, light-chain and nonsecretory myeloma, and malignant lymphoma. Thus, using immunoperoxidase methods, antisera that clearly discriminate between the different immunoglobulin light and heavy chains in reactive plasma cell populations, and in the majority of cases of multiple myeloma, fail to recognize and distinguish the immunoglobulin components produced by certain neoplastic plasma cells. Several possible explanations for this observation are considered.