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Diagnosis of Hematologic Malignancies: 2nd Edition

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Dr. Leonor Arenillas

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1. Hematological Cytology Laboratory, Pathology Department, Hospital del Mar, 08003 Barcelona, Spain
2. Translational Research on Hematological Neoplasms Group, Cancer Research Program, Hospital del Mar Research Institute (HMRI), 08003 Barcelona, Spain
Interests: hematologic malignancies diagnosis; cytomorphology; flow cytometry; myeloid neoplasms; myelodysplastic syndromes; acute myeloid leukemia
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Dr. Xavier Calvo

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Dear Colleagues,

This Special Issue is a continuation of our previous Special Issue, “Diagnosis of Hematologic Malignancies”.

In recent years, we have experienced a change in the paradigm of the diagnosis of hematological malignancies, moving from phenotyping to genotyping, and giving increasing importance to multidisciplinary diagnoses. An accurate diagnosis is necessary for a correct prognostic stratification and an adequate choice of therapy. Although morphology continues to represent the indispensable starting point in the diagnostics of hematological neoplasms, new classifications tend to define nosological entities based on the underlying genetic mechanisms of disease. The World Health Organization’s (WHO) classification of tumors of hematopoietic and lymphoid tissues has provided a global reference for the diagnosis of hematological neoplasms since its third edition in 2001. This classification is based on integrating morphologic (cytology and histology), immunophenotypic, molecular, and cytogenetic data. Recently, in addition to the 2022 edition of the WHO classification, the International Consensus Classification (ICC) system for hematological neoplasms has been published. While many definitions proposed by the ICC and WHO 2022 are concordant, some differ in a number of key aspects and could impact the design of clinical trials, drug development, and regulatory approval, in addition to, as a consequence, patient care. With this, the current Special Issue aims to highlight novel diagnostic and prognostic tools that could improve the management and treatment of hematological neoplasms—we look forward to your contributions.

Dr. Leonor Arenillas
Dr. Xavier Calvo
Guest Editors

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15 pages, 996 KB

Open AccessArticle

Pleuro-Pulmonary Extramedullary Plasmacytomas in Multiple Myeloma: A 15-Year Experience from a Tertiary Center

by Sorina Badelita, Sinziana Barbu, Camelia Dobrea, Cerasela Jardan, Monica Popescu, Codruta Delia Popa, Claudia Toma, Larisa Zidaru, Mihai Emanuel Himcinschi, Horia Mihail Sandu, Didona Vasilache, Adelina Vlad and Daniel Coriu

Cancers 2026, 18(1), 19; https://doi.org/10.3390/cancers18010019 - 20 Dec 2025

Viewed by 546

Abstract

Background/Objectives: Extramedullary involvement in multiple myeloma represents an aggressive disease phenotype, associated with reduced survival and an unfavorable prognosis. Thoracic manifestations are rare and remain poorly characterized in the literature. Methods: We conducted a retrospective, single-center study at the Fundeni Clinical Institute, including patients diagnosed with multiple myeloma between February 2010 and February 2025. The study cohort consisted of 34 patients with infiltration of the pulmonary parenchyma, pleura, or the presence of myelomatous pleural effusion. Diagnosis was confirmed using a combination of imaging modalities (computed tomography or magnetic resonance imaging), cytological examination, immunophenotyping, and histopathological confirmation whenever feasible. Results: Out of a total of 2012 patients with multiple myeloma, the incidence of pleuro-pulmonary extramedullary involvement was 1.6%. The median age at diagnosis was 58 years. Pleuro-pulmonary disease was present at initial diagnosis in 26.5% of cases, while 73.5% developed it at relapse. The most common presentation involved combined pleural involvement and myelomatous effusion (70.6%). Adverse prognostic markers included elevated β2-microglobulin levels (in over 80% of cases) and increased lactate dehydrogenase (LDH) in approximately 50%. Cytogenetic abnormalities such as del(17p), t(4;14), t(14;16), t(11;14), and 1q gain were identified. The median overall survival (OS) from the diagnosis of pleuro-pulmonary extramedullary disease was 16 months, with a 2-year survival rate of 25%. No patient survived beyond 5 years. The median progression-free survival (PFS) was 9 months. Conclusions: Our findings confirm the aggressive clinical course and poor prognosis of these disease manifestations, mainly when they occur at relapse. In the absence of standardized treatment guidelines, individualizing therapy and accessing novel strategies may be essential for improving patient survival. Full article

(This article belongs to the Special Issue Diagnosis of Hematologic Malignancies: 2nd Edition)

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