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Solitary plasmacytoma of the spine: relationship of IGM to tumour progression and recurrence.

The authors report a retrospective study of 15 patients with solitary vertebral plasmacytoma. 15 patients were considered in this study on the basis of the following characteristics: 1) histologically confirmed plasmacytoma following surgical removal; 2) existence of a single vertebral lesion, documented by skeletal and MRI scan; 3) no signs, at diagnosis of disseminated disease by blood laboratory test, urine analysis, sternal puncture, iliac bone marrow biopsy, a total-body CT scan. The clinical course of the patients has been analysed on the basis of the following factors: age, sex, length of clinical history before diagnosis, site, presence/absence of the M component. The M component is an electrophoretically homogeneous immunoglobin. The most significant factors for predicting development of multiple myeloma proved to be the presence /absence of the M component at diagnosis and, to a lesser degree, the age of the patient. In the light of other reports too, it would seem that the presence of the M component at diagnosis is a reflection of aggressive biological and clinical tumour behaviour.

Adult↗

Solitary plasmacytoma: a case report.

We report a case of solitary vertebral plasmacytoma that was peculiar in mode of onset and neurological course. The clinical and radiological evidence pointed to a generic diagnosis of epidural osteolytic process while electroimmunophoresis of blood narrowed the diagnosis to spinal plasmacytoma, confirmed at operation.

Female↗

Spontaneous regression of extramedullary plasmacytoma--a case report.

A case of extramedullary plasmacytoma in the soft tissues of the posterior chest wall of an 80-year old man is reported herein. Immunofluorescence study showed that the tumor cells produced IgG lambda. An M-component was also detected in the patient's serum by paper electrophoresis. Two months following the open biopsy done to establish diagnosis, the tumor underwent spontaneous regression and the M-component in the serum also disappeared. This is the first case report of spontaneous regression of an extramedullary plasmacytoma and the probable reasons for this spontaneous regression are discussed herein.

Aged↗

Extramedullary plasmacytoma of the small intestine: first case report of ileocolic fistula and review of the literature.

Extramedullary plasmacytoma (EMP) of the small bowel is a rare entity previously reported as a cause of intestinal obstruction or bleeding. A case report of this disease entity presenting as an ileocolic fistula is reported. EMP is diagnosed by the following criteria: 1) absence of paraproteinemia; 2) absence of Bence Jones proteinuria; 3) normal skeletal survey; and 4) normal bone marrow biopsy specimen. Gastrointestinal plasmacytoma often occurs as a manifestation of multiple myeloma. EMP of the gastrointestinal tract is a rare manifestation of the disease, accounting for 13 per cent of all cases of EMP. It is a slow-spreading, radiosensitive tumor with a high tendency toward local recurrence. Surgical excision combined with radiotherapy is the treatment of choice for EMP of the gastrointestinal tract.

Humans↗

Gastric plasmacytoma with cylindrical crystalline inclusions.

An 81 year-old female case of extramedullary plasmacytoma of the stomach is reported. Immunohistochemically, the tumor cells contained IgM-lambda immunoglobulin. Electron micrographs of the tumor cells showed centrally located nuclei with nuclear inclusions and cytoplasm filled with crystalline inclusions in the rough endoplasmic reticulum. IgM-lambda producing gastric plasmacytoma with cylindrical inclusions is rare.

Aged↗

Primary eyelid plasmacytoma.

We report a case of eyelid plasmacytoma. The patient presented with a superficial lesion on the upper left eyelid, 10x7 mm in size. Histological and immunohistochemical findings were indicative of plasmacytoma with slightly abnormal sub-epidermic plasma cell infiltrates. Immunoperoxidase staining was strongly positive for intracytoplasmic kappa light chains. No infiltration by atypical plasma cells could be documented in the bone marrow biopsy and aspirate. Skeletal survey showed no osteolytic lesions or osteoporosis. The tumor on the left eyelid was surgically removed. No radiotherapy was administered.

Adult↗

Solitary plasmacytoma of the spine in an adolescent: a case report.

Solitary plasmacytoma of bone is a rare disease in patients younger than 30 years, and only a few cases have been reported in children and adolescents. We report the findings of a destructive lesion of the spine due to solitary plasmacytoma in an adolescent patient.

Adolescent↗

Osseous metaplasia associated with amyloid-producing plasmacytoma of bone: a report of two cases.

Amyloid-producing plasmacytoma of bone is a rare myeloma variant. We describe two patients with plasmacytomas of bone with extensive amyloid deposition and metaplastic bone formation which can be confused on imaging with osteosarcoma. Histologic confirmation was obtained in both cases. Metaplastic new bone formation was identified within these lesions and appears to be responsible for the radiographic appearances.

Aged↗

Solitary osteosclerotic plasmacytoma: association with demyelinating polyneuropathy and amyloid deposition.

A 51-year-old man presented with a 1-year history of polyneuropathy necessitating the use of a wheelchair. Initial diagnosis was idiopathic chronic inflammatory demyelinating polyneuropathy (CIDP) and associated monoclonal gammopathy. Investigations for multiple myeloma, including bone marrow aspiration and biopsy, were negative. What was initially felt to be an incidental osteosclerotic focus noted on the radiographic bone survey was eventually shown to be a solitary osteosclereotic plasmacytoma with associated amyloid. This dramatically altered treatment. This case emphasizes the importance of including osteosclerotic plasmacytoma in the differential diagnosis of a focal sclerotic bone lesion in the clinical setting of polyneuropathy. These lesions are less likely to progress to multiple myeloma than lytic plasma cell neoplasms, and the presence of polyneuropathy often results in earlier diagnosis and treatment with enhanced prospect of cure. The finding of amyloid deposition within the osteosclerotic lesion may be of prognostic importance.

Amyloid↗

An indolent course of multiple myeloma mimicking a solitary thyroid cartilage plasmacytoma.

Multiple myeloma, solitary plasmacytoma, and extramedullary plasmacytoma constitute a continuum of a disease spectrum, which is called plasma cell neoplasms. These three entities can not be differentiated from each other on a histological basis and, for this reason, clinical evaluation is important in their differential diagnoses. Differential diagnosis guides the proper planning of treatment and helps in estimation of survival. Multiple myeloma located within the larynx is very rare. Because of its rarity, any established diagnostic and treatment criteria do not exist. In this report, a case of laryngeal multiple myeloma is presented for its extraordinary presentation and also for educational purposes.

Aged↗

Anaplastic plasmacytoma with malignant pleural effusion lacking evidence of monoclonal gammopathy.

A case of plasmacytoma of the pleural cavity is reported with massive malignant pleural effusion, which, most unusually, lacked monoclonal gammopathy, thereby making it difficult to distinguish from lymphoma. The pleural tumor and pleural effusion contained large mononuclear lymphoma-like cells with distinct nucleoli. Immunohistochemistry revealed neither lymphoma markers nor clonal cytoplasmic nor cell surface immunoglobulins. Tumor cells were stained with vimentin and the plasma cell markers, VS38c, CD138 (syndecan-1), and MUM1 antibodies. Bone marrow contained small amounts of tumor consisting of similar cells. Electron microscopy showed well developed rough endoplasmic reticulum and peripherally positioned nuclei with euchromatin. Flow cytometry of bone marrow revealed a minimal involvement of CD38-positive cells. Chromosomal analysis of marrow cells revealed a complex abnormal karyotype. A polymerase chain reaction demonstrated clonal re-arrangement of the immunoglobulin heavy-chain gene. The overall results indicate a clonal expansion of tumor cells with primitive plasma cell differentiation with the highly unusual feature of absent monotypic immunoglobulin. The study illustrates the need for a comprehensive array of techniques to distinguish such rare non-synthesizing and non-secretory plasmacytomas from lymphoma.

Aged↗

Intrasellar plasmacytoma presenting as a non-functional invasive pituitary macro-adenoma: case report & literature review.

We report an uncommon case of an intrasellar plasmacytoma presenting as a non-functional invasive pituitary macro-adenoma as the first manifestation of multiple myeloma. A 57 year old woman was referred to our department with a presumed diagnosis of a non-functioning pituitary macro-adenoma. She reported a 3 month history of headaches and a 2 week history of sudden onset of right facial numbness. Preoperative endocrine evaluation was remarkable only for a modestly elevated serum prolactin. A magnetic resonance imaging (MRI) scan revealed 3.6 x 5 x 4 cm enhancing homogeneous intrasellar mass with extension into the sphenoid and cavernous sinuses bilaterally; the optic chiasm was not displaced. She underwent transphenoidal surgery of the sellar lesion. The surgical specimen was heavily infiltrated with abnormal plasma cells, which stained almost exclusively for Kappa light chain immunoglobulins. An extensive investigation was undertaken to look for occult myelomatous disease. A diagnosis of multiple myeloma was made 1 month later based on a combination of clinical, pathological and radiologic features. She underwent radiation therapy directed towards the residual sellar tumor, followed by chemotherapy and autologous stem cell transplantation. Review of the world literature revealed only 22 previous reports of patients in whom a solitary plasmacytoma or multiple myeloma first presented as a sellar mass; in all cases mimicking clinically and radiologically a non-functioning invasive pituitary adenoma however with additional cranial nerve involvement. Intrasellar plasma cell tumors are rare tumors which may mimic non-functioning invasive pituitary tumors. The diagnosis should be suspected in patients with well preserved anterior pituitary function and cranial nerve neuropathies in the presence of significant sellar destruction.

Adenoma↗

Solitary plasmacytoma of the sternum: surgical resection with long-term follow-up.

Two patients with solitary plasmacytoma of the sternum were treated with primary surgical resection. Good long-term results were obtained. There is no long-term documentation that primary radiotherapy alone is the treatment of choice for solitary plasmacytomas. An individualized approach is warranted, especially when there is an isolated bulky lesion involving the chest wall.

Aged↗

Messenger RNA binding of a ribosome-associated protein kinase and a ribosomal phosphoprotein(s) in mouse plasmacytoma.

A specific ribosome-associated protein kinase (protein kinase II) and phosphoprotein(s) from the ribosomal KCl wash fraction termed "PPx" have been isolated from plasmacytoma, and tested for their ability to bind to poly(A) and to different plasmacytoma polynucleotides. The nitrocellulose filter binding technique was used to measure RNA-protein interaction. Protein kinase II and PPx preferentially bound mRNA compared to poly(A). They did not bind ribosomal RNA, soluble RNA or DNA. The optimal conditions (temperature, time, protein concentration, ionic strength) for mRNA-protein interaction were determined. Ribosomal protein kinase (protein kinase II) phosphorylated PPx proteins which bound to mRNA represented at least two bands as determined by sodium dodecyl sulphate polyacrylamide gel electrophoresis (Mr = 90 000 and 80 000). The high affinity of protein kinase II and PPx for mRNA suggests that they may function in regulating protein synthesis.

Adenosine Triphosphate↗

The effect of TEPC-183 plasmacytoma growth on beta-glucuronidase activity in serum and tissues of tumor-bearing mice.

beta-Glucuronidase activity increased in the serum of BALB/c mice during the growth of the IgM-secreting plasmacytoma, TEPC-183. The increase appeared to correlate with tumor burden. The beta-glucuronidase activity in tissue homogenates of spleen, liver, and kidney from tumor-bearing mice also increased significantly compared to the levels found in corresponding tissues from normal control mice. Assays of lysosomal and microsomal fractions from livers of TEPC-bearing mice indicated that approximately 70% of the enzyme activity was associated with the lysosomal fraction and the remainder with the microsomal fraction. A similar distribution was found in homogenates prepared from the plasmacytoma itself. In contrast to this the beta-glucuronidase activity in livers from normal BALB/c mice is nearly equally distributed between lysosomal and microsomal fractions.

Animals↗

Effects of sodium butyrate on the rearranged c-myc expression in mouse plasmacytoma cells.

The expression of c-myc mRNA was examined after 4 h of sodium butyrate treatment in a mouse plasmacytoma (MPC) cell line (S194). Steady-state levels of rearranged c-myc mRNA were suppressed by the agent in S194 cells. Run-on assay demonstrated that the suppression of the rearranged c-myc mRNA in the MPC was correlated with the transcriptional downregulation of the gene. The suppression was also accompanied by the reduced DNase I sensitivity of the gene. These findings suggest that the rapid downregulation of c-myc mRNA by sodium butyrate is subject to regulation at the transcriptional level following the alteration of the DNase I sensitive chromatin structure in mouse plasmacytoma cells.

Animals↗

Induction of plasmacytomas that secrete monoclonal anti-peptide antibodies by retroviral transformation.

ABL-MYC, a retrovirus that coexpresses v-abl and c-myc, was used to infect six BALB/c mice that had been immunized twice with a KLH-conjugated peptide that consisted of the 18 carboxyterminal amino acids of protein kinase C-eta (PKC-eta). All mice developed transplantable, monoclonal plasmacytomas, and five out of six plasmacytomas secreted antigen-specific antibodies, even after transplantation. All these antibodies recognized PKC-eta on Western blots of crude cell lysates and did not cross react with other isoforms of the PKC family.

Amino Acid Sequence↗

The ABL-MYC retrovirus generates antigen-specific plasmacytomas by in vitro infection of activated B lymphocytes from spleen and other murine lymphoid organs.

ABL-MYC is a recombinant retrovirus that constitutively expresses the v-abl and c-myc oncogenes. When used to infect immunized mice this virus rapidly and efficiently induces plasmacytomas of which an unusually high percentage secrete antigen (Ag)-specific monoclonal antibodies. These findings suggested that ABL-MYC targets Ag-stimulated B cells for transformation and that infection of lymphoid cells in vitro might be a useful, alternative method for generating monoclonal, Ag-specific plasmacytomas (ASPCTs). Therefore, we used helper virus-free ABL-MYC to infect suspensions of cells from spleens and other lymphoid organs from mice that had been immunized with a variety of Ags and transplanted them into naive mice. The results show that ABL-MYC preferentially transforms splenocytes that are Ag-reactive. They also demonstrate that ASPCTs can be produced by in vitro infection of cell suspensions from the spleen, lymph nodes and Peyer's patches of mice that had been immunized intraperitoneally with sheep red blood cells, Escherichia coli core RNA polymerase or Epstein-Barr virus gp340 protein or immunized orally with live Giardia lamblia parasites. The ASPCTs usually consisted of one to three colnes, secreted antibodies that were quantitatively and qualitatively similar to those obtained from hybridomas, and could continue to secrete Ag-reactive antibody over eight transplant generations.

Animals↗