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PubMed2006

Radiologic manifestations of primary solitary extramedullary and multiple solitary plasmacytomas.

OBJECTIVE: Primary solitary extramedullary and multiple solitary plasmacytomas are rare manifestations of plasma cell tumors. This study reviews their imaging spectrum in 12 patients. CONCLUSION: Imaging features of primary solitary extramedullary and multiple solitary plasmacytomas are nonspecific but are compatible with solid tumors that are isointense on T1-weighted images and iso- to hyperintense on T2-weighted images relative to muscle and white matter with variable enhancement. Large tumors may show necrosis and destruction, infiltration, or encasement of adjacent structures. Multiplicity of lesions and regional lymphadenopathy were evident on imaging in only five cases each. Imaging alone cannot differentiate these tumors from more common malignant entities such as carcinoma, meningioma in cases of intracranial extramedullary plasmacytomas, or metastasis from other primaries. The role of imaging should be focused on early detection of additional or recurrent lesions and the presence of regional lymphadenopathy, which will influence clinical management.

Diagnosis, Differential↗
PubMed2000

The "mini brain": plasmacytoma in a vertebral body on MR imaging.

OBJECTIVE: Patients with solitary plasmacytoma in the spine frequently require a biopsy for diagnosis of their condition. We report an appearance of plasmacytoma in the spine, which is sufficiently pathognomonic to obviate biopsy. CONCLUSION: Identification of a "mini brain" in an expansile lesion in the spine is characteristic of plasmacytoma. It is important that radiologists note this characteristic because biopsy can be avoided in patients with this appearance. Although biopsy might still be required at many institutions, at our institution, surgeons find this appearance sufficiently pathognomonic to bypass biopsy and start treatment.

Adult↗
PubMed2000

Breast plasmacytoma.

An unusual case of breast plasmacytoma associated with a multiple myeloma is reported. Breast plasmacytoma is exceedingly rare. We identified 37 cases published between 1928 and 1999, and reviewed the clinical features of this unusual presentation of plasmacytoma.

Aged↗
PubMed2001

Primary extramedullary plasmacytoma of the lacrimal gland.

Primary extramedullary plasmacytoma (EMP) of the lacrimal gland is rare. Here we describe the histopathologic and imaging findings in a 77-year-old patient with primary extramedullary plasmacytoma of the lacrimal gland. The usefulness of CD79a in the diagnosis of plasmacytoma and the good response of the tumor to combined surgery and radiotherapy are illustrated. Plamacytoma should be included in the differential diagnosis of lacrimal tumors.

Aged↗
PubMed1996

Multifocal plasmacytoma of hand and foot bones.

Simultaneous occurrence of localized plasmacytomas of both hands and feet has not been reported so far. Here we report a 40-year old female patient, who had at presentation pain and deformity. Of hands and feet, with numerous cystic lytic lesions of phalangeal, metacarpal and metatarsal bones, detected by X-rays. The biopsy of the affected bone showed moderately differentiated plasmacytoma of lambda light chain type (lambda-LC). Serum and urine biochemical analysis revealed the existence of lambda LC monoclonal component. The patient was treated by local radiotherapy and subsequent systemic chemotherapy, which consisted of 3 cycles of the M-2 protocol and 7 cycles of melphalan-prednisone. Five years after the diagnosis, the absence of plasmacytoma was confirmed by puncture biopsy of the left hand phalanx. Monoclonal protein in serum and urine was not detected.

Adult↗
PubMed1997

Cleaved variant of plasmacytoma with myelomonocytic differentiation--immunohistochemical and ultrastructural studies.

Although plasma cells are terminally differentiated B cells, neoplastic plasma cells frequently express not only pre-B cell antigen, but also megakaryocytic, myelomonocytic, or erythroid markers. Since morphologic diagnosis of plasmacytoma is based on the recognition of neoplastic cells closely resembling normal plasma cells, unusual morphologic variants of neoplastic cells associated with these aberrant immunohistochemical features frequently cause diagnostic difficulty. The authors report a case of plasmacytoma with cleaved nuclei and myelomonocytic features occurring in the clavicle. The tumor was composed of immature plasma cells showing irregular, cleaved, and multilobated nuclei and abundant cytoplasm with prominent eosinophilic granules. A few tumor cells showing recognizable plasmacytic differentiation were admixed within the tumor. Immunohistochemically, the tumor cells expressed CD45RB, CD68, lysozyme, myeloperoxidase and kappa light chain with focal positivity for lambda chain. Ultrastructurally, the tumor cells contained numerous membrane bound electron dense lysosomal granules, some of them resembling Auer rods, as well as rough endoplasmic reticula arranged in lamellated stacks. Small biopsied nasal mucosal tissue in same patient revealed well differentiated plasmacytoma composed of tumor cells showing round, eccentric nuclei devoid of marked nuclear cleavage and cytoplasmic granularity. Immunohistochemically, these cells were kappa(+), lambda(-), myeloperoxidase(-), lysozyme(-) and CD68(-).

Adult↗
PubMed2006

Plasmacytoma in the breast with axillary lymph node involvement: a case report.

Plasmacytic tumors in the breast are extremely rare neoplasms that can mimic mammary adenocarcima. A literature review revealed approximately 43 reports worldwide of plasmacytic tumors in the breast since 1928, the majority with a synchronous diagnosis of multiple myeloma. We discuss management of a 78-year-old man with plasmacytoma in the breast who underwent a left total mastectomy and axillary lymph node dissection. This report characterizes the histologic and immunochemical characteristics of plasmacytoma in the breast and reviews the consensus on treatment. This could be the first recorded account of plasmacytomas in the breast with axillary lymph node involvement and extracapsular extension of tumor.

Aged↗
PubMed1999

Among numerous DNA copy number changes, losses of chromosome 13 are highly recurrent in plasmacytoma.

Chromosomal imbalances were studied by comparative genomic hybridization (CGH) on 27 specimens from 24 patients with plasmacytoma. All the specimens exhibited DNA copy number changes (mean, 7.7 aberrations/tumor; range, 2-15). The most recurrent change involved losses at 13q, found in 19 out of 24 patients. Other frequent losses were at 1p (42%), 14q (33%), X (33%), 8p (25%), and 6q (25%). Gains were frequent at 19p (58%), 9q (58%), 1q (58%), 7p (42%), 11q (38%), 15 (33%), 6p (25%), 8q (25%), and 5p (21%). High-level copy number increases were found at 1q, 5, 7, 8q, 9q, 11q, 15, and 19. The findings of highly recurrent chromosomal imbalances in plasmacytomas confirm the analytical power of CGH to detect chromosomal abnormalities in malignancies characterized by low mitotic activity. Our most striking finding, the losses in chromosome 13, provides a basis to investigate the role of the 13q loss in the tumorigenesis and progression of plasmacytoma and to evaluate the prognostic significance of this loss.

Adult↗
PubMed1999

Elevated mutant frequencies in lymphoid tissues persist throughout plasmacytoma development in BALB/c.lambdaLIZ mice.

Using the phage lambdaLIZ-based transgenic in vivo mutagenesis assay, the mean mutant frequencies in the target gene, lacI, were found to be significantly increased in lymphoid tissues of congenic BALB/c.lambdaLIZ N5 mice in the terminal stage of a plasmacytoma induction experiment, 213-280 days after the first i.p. injection of the plasmacytomagenic agent pristane (2,6,10,14-tetramethylpentadecane). In plasmacytoma-bearing mice (n = 7), mutant frequencies in the spleens and mesenteric lymph nodes were elevated 2.46-fold and 5.35-fold, respectively, when compared with age-matched controls. In plasmacytoma-negative mice (n = 11), mutant frequencies were increased 2.30-fold (spleens) and 3.48-fold (mesenteric nodes). These results, interpreted in conjunction with our previous findings (K. Felix et al., Cancer Res., 58: 1616-1619, 1998) of approximately 3-fold elevations in pristane-induced splenic mutagenesis on day 42 postpristane, indicate that increased mutant levels in lymphoid tissues persist throughout plasmacytomagenesis in genetically susceptible BALB/c mice.

Animals↗
PubMed2000

[Solitary plasmacytoma of the cranial vault. Case report and review of the literature].

We report a case of solitary plasmacytoma of the cranial vault. A 58-year-old man presented with a frontal soft tissue mass. X-Ray of the skull showed a lytic lesion of the frontal bone. CT scan showed the lesion extending intra and extracranially and cerebral angiography allowed embolization of afferent arteries. Complete removal of the lesion was performed without additional radiotherapy. Two years after surgery the patient is alive, and asymptomatic. Until 1997, 35 cases of solitary plasmacytoma of the cranial vault are reported, of which only five had frontal localisation. Solitary plasmacytoma of the cranial vault has a good outcome but progression towards a multiple myeloma is possible and deserves clinical and biological follow-up.

Humans↗
PubMed2000

[Solitary extramedullary plasmacytoma of the rhinopharynx].

Solitary extramedullary plasmacytoma involving the nasopharynx is very rare. A case of asymptomatic extramedullary plasmacytoma in the nasopharynx in a 69-year-old man is presented. Radiotherapy was the treatment (60 Gy). In this patient two neoplasms of B series are associated (lymphoproliferative B Kappa syndrome and extramedullary plasmacytoma).

Aged↗
PubMed2000

Sixth nerve palsy as a presenting sign of intracranial plasmacytoma and multiple myeloma.

Multiple myeloma and plasmacytoma are rare causes of mass lesions at the skull base and cavernous sinus. Sixth nerve palsy, in isolation or in combination with other cranial neuropathies, may occur rarely as the initial presenting feature of multiple myeloma. We report the neuro-ophthalmologic, radiologic, and pathologic findings for two patients who developed sixth nerve palsies as an initial manifestation of intracranial plasmacytoma and multiple myeloma. One patient presented with an isolated sixth nerve palsy in the setting of multiple vasculopathic risk factors. Treatable skull base lesions, including plasmacytoma and multiple myeloma, must be considered in patients with sixth nerve palsies, especially among those who demonstrate a progressive course or multiple cranial neuropathies.

Abducens Nerve Diseases↗
PubMed2001

Solitary plasmacytoma of the mesentery with nodular amyloid deposits: a case report with immunohistochemical evaluation.

The mesentery is unusual site for plasmacytoma. We have observed a solitary primary mesenteric plasmacytoma with marked nodular deposits of Congophilic amyloid in a 38 year-old man. We believe the present case represents the first case of primary extraosseous mesenteric plasmacytoma in the English literature. The clinical picture, pathologic findings and immuno-histochemical studies are discussed. Autopsy and long-term follow up are needed to determine whether this patient is at risk of developing multiple myeloma, local recurrence, metastatic foci or probable complications related to amyloidosis.

Adult↗
PubMed2001

[Renal plasmacytoma. Report of a new case].

OBJECTIVE: To present a case of extramedullary plasmacytoma localized in the kidney. The clinical features, diagnostic tests, treatment and outcome are discussed. METHODS/RESULTS: A 59-year-old patient presented with a right renal mass and renal failure. The complementary tests showed a lambda monoclonal band in blood and urine, and a left renal biopsy showed changes compatible with myeloma. The definitive diagnosis of plasmacytoma was based on the findings of open renal biopsy since fine needle punction findings were compatible with a carcinoma. The patient received polychemotherapy, but died one year after the diagnosis due to a rapidly progressing plasmatic cell dyscrasia. CONCLUSION: Renal plasmacytoma is rare and should be suspected when paraprotein is detected in blood and urine, and when the patient has a history of plasmatic cell dyscrasia. There is no widely-established treatment. Surgery, radiotherapy or chemotherapy, alone or in combination, can be utilized.

Humans↗
PubMed2001

[A case of plasmacytoma involving adrenal gland].

We report a case of extramedullary plasmacytoma involving the right adrenal gland. A 52-year-old male was introduced under diagnosis of right adrenal tumor which was found incidentally by computerized tomography in a health check up. Laboratory data showed the presence of M protein and elevation of monoclonal lambda type IgG. It was a hormonally non-active tumor involving the adrenal area. Extramedullary plasmacytoma was confirmed by histological analysis of the resected specimen after laparoscopic right adrenalectomy. Extramedullary plasmacytoma is an uncommon neoplasm and occurs most frequently in the upper respiratory tract and is fairly rare in the adrenal area.

Adrenal Gland Neoplasms↗
PubMed1975

Preparation and properties of an antiplasma cell serum directed against a defined plasmacytoma cell population.

Heterologous antisera were prepared against a subpopulation of MOPC-104E tumor cells obtained by centrifugation on discontinuous BSA gradients as well as against cells from the whole tumor mass. The gradient-separated cells were more effective than the cells from the whole tumor mass in eliciting antisera not only higher titer, but also with greater specificity for plasmacytoma antigens. The unabsorbed antiserum prepared against the gradient-separated plasmacytoma population was cytotoxic for murine lymphoid cells, but not for murine kidney, liver, or brain cells. After in vitro absorption with murine thymocytes and removal of anti-immunoglobulin activity by affinity chromatography, the antiserum was found to be reactive against plasmacytoma cells, but was no longer cytotoxic for murine thymus or unstimulated spleen cells. This absorbed antiserum was also cytotoxic for LPS-, but not PHA- or Con A-stimulated normal murine spleen cells.

Animals↗
PubMed2002

[Isolated intrapulmonary plasmacytoma; diagnostic and therapeutic difficulties].

Localised intrapulmonary plasmacytoma represents less than 5% of all extramedullary plasmacytomas. Their diagnosis is usually made difficult by a radiological presentation and non specific endoscopic findings as well as non contributory biochemical and cytological data. This often justifies the recourse to more invasive histological investigation aided by immunohistochemical techniques. We report the case of a patient who presented with an isolated plasmacytoma in the form of two parenchymatous pulmonary masses and who was treated by a combination of surgical resection and external radiotherapy. A search for multiple intraosseous myeloma remained negative. Unfortunately a relapse in the form of mediastinal invasion occurred 6 months after the completion of treatment and led to the death of the patient.

Aged↗
PubMed2002

[Solitary plasmacytoma of the sphenoid. A case report].

A rare case of sphenoidal plasmacytoma in a 79 year-old male patient is reported. The diagnosis was preoperatively considered because of associated dysproteinemia and it was histopathologically confirmed on a transphenoidal biopsy specimen. Initial evaluation disclosed no systemic dissemination of the disease and a solitary plasmacytoma was diagnosed. Radiotherapy was delivered with subsequent clinical improvement and significant tumor reduction was illustrated on follow-up imaging studies. Twenty-two months after diagnosis, the patient remains asymptomatic without evidence of transformation to multiple myeloma. Only 7 comparable cases have been reported in the literature. The diagnostic, pathological and nosographic features of sphenoid plasmacytomas are discussed.

Aged↗