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PubMed2001

Multiple myeloma associated with extramedullary plasmacytoma causing nerve root compression: a case report.

Multiple myeloma associated with extramedullary plasmacytoma at initial presentation is rare. We describe a 45-year-old female patient with an initial presentation of low back pain and right side L5, S1 radiculopathy. There was no evidence of vertebral involvement but an epidural tumor was found later during neurosurgical intervention. The final diagnosis was immunoglobulin G, kappa multiple myeloma complicated with spinal root compression by an extramedullary plasmacytoma. No osteolytic lesion was noted over the length of the spine. Pathology revealed high-grade plasmablastic myeloma. During the clinical course, the patient was refractory to induction chemotherapy, and there was progressive deterioration of renal function. Urinary tract infection by Morganella morganii and pulmonary infection of unknown cause developed 5 months later, and the patient died.

Female↗
PubMed2001

[Gross spreading multiple extramedullary plasmacytomas to the skin in the terminal stage of multiple myeloma].

A 71-year-old woman with an 8-year history of IgG-kappa type multiple myeloma was admitted because of severe lumbago and bone destruction. Her serum IgG level was elevated to 5,565 mg/dl at admission. Despite treatment with doxorubicin, vincristine, dexamethasone, melphalan and interferon-alpha, the response was transient. Nine months later, multiple skin nodules appeared on her chest, abdominal wall and right thigh accompanied by elevation of the serum IgG level. Response to combination chemotherapy with cyclophosphamide, ranimustine, vincristine and prednisolone was also transient. The skin tumors on the bilateral thighs, especially on the left side, acquired chemotherapy resistance and gradually enlarged. Although the serum IgG level was maintained by chemotherapy within the range 1, 790-2,676 mg/dl, the skin tumors on the left thigh had spread very rapidly and appeared "rock-like". The enlarged tumors caused necrosis with erosions and oozing hemorrhage. A skin biopsy from the tumors on the left thigh showed plasmacytoma in which infiltration of large anaplastic plasma cells was observed. The patient died of sepsis 8 months after the skin tumors initially developed. This is a very rare case of multiple myeloma in which multiple large plasmacytomas of the skin developed and grew aggressively at the terminal stage after a long-term indolent course.

Aged↗
PubMed2001

Plasmacytoma of the temporal bone: management with a combination of surgery and radiotherapy.

The diagnosis of solitary plasma cell neoplasm is based on clinical, radiological and laboratory findings and it can be accepted as the precursor lesion of multiple myeloma as spread of disease occurs in 30-50% of affected patients. However, solitary plasmacytoma of the temporal bone is a rare pathology. We present an interesting case of plasmacytoma of the temporal bone which was controlled by a combination of surgery and radiotherapy.

Aged↗
PubMedDate not supplied

CT-pathologic correlation in a case of solitary plasmacytoma of the rib.

We report a case of solitary plasmacytoma of rib origin in a 46-year-old man. CT revealed a focal expanding mass in the right fifth rib. The mass showed ridging, cortical thickening, and fine erosion on the inner aspect of the cortex and had partly penetrated the bone. On both T1- and T2-weighted MR images, the mass showed low to intermediate intensity, and contrast studies showed homogeneous enhancement. Whole body bone scintigraphy revealed abnormal solitary accumulation, and therefore surgical resection was performed. Macroscopically the specimen revealed destruction of the cortex caused by tumor invasion, corresponding to the CT findings. Microscopic findings included a large number of plasma cells, leading to a histopathological diagnosis of plasmacytoma.

Bone Neoplasms↗
PubMedDate not supplied

Primary cutaneous plasmacytoma on chronic lymphoedema.

An unusual case of cutaneous plasmacytoma with multiple lesions in a 77-year-old man affected by chronic lymphoedema of his lower limbs is reported. Histopathology and immunohistochemical staining led to the diagnosis of cutaneous plasmacytoma. Staging studies were not able to identify extracutaneous involvement. The lesions were successfully treated with melphalan and prednisone. No signs of progression of the disease were seen at a 2- year follow-up.

Aged↗
PubMedDate not supplied

IgM plasmacytoma. Report of a case and review of the literature.

IgM paraproteinaemia is described in a patient with diffuse plasmacytoma involving the pleura, lymph nodes, and kidneys. Sixteen cases of pure plasmacellular tumor (diffuse or solitary plasmacytoma and plasmacellular leukaemia) associated with IgM paraproteinaemia have only been reported. These cases and experimental data indicate that neoplastic plasma cells can synthetize IgM as well as other immunoglobulins and that this particular M component is not associated solely with Waldenström's macroglobulinaemia.

Chromatography, Gel↗
PubMed2002

Solitary plasmacytoma of the skull bone.

Solitary plasmacytoma of the bone is an uncommon variety of plasma cell tumour. Here an interesting case of solitary plasmacytoma of the skull bone, which is extremely rare, is being reported.

Aged↗
PubMedDate not supplied

CT and MR imaging of solitary extramedullary plasmacytoma of the nasal tract.

BACKGROUND AND PURPOSE: Solitary extramedullary plasmacytoma (SEP) is rare. The purpose of this study was to determine the CT and MR imaging features of SEP of the nasal tract. METHODS: We retrospectively reviewed three CT and two MR images of three histologically proved cases in two men and one woman aged 43-66 years. RESULTS: The plasmacytomas predominantly involved the nasopharynx in two cases and the nasal cavity in one. Two of the tumors were bulky solid masses, whereas the third showed infiltrative features. They were predominantly masses or infiltrative lesions with soft-tissue attenuation on CT scans. The lesions were isointense and hyperintense on T1- and T2-weighted MR images, respectively. The tumors revealed moderate-to-marked contrast enhancement and may have been associated with lytic bone destruction. CONCLUSION: The imaging features of SEP are nonspecific. However, this entity should be included in the differential diagnosis of tumors in the nasopharynx and nasal cavity.

Adult↗
PubMed1992

[Aspects and role of spinal MRI in the assessment of solitary plasmacytoma and multiple myeloma. Apropos of 11 cases].

Spinal MRI was performed in 9 multiple myeloma and 2 solitary plasmacytoma, using sagittal, T 1-weighted (TR: 350-550 ms/TE: 15-26 ms) and T 2-weighted (TR: 2,000-2,500 ms/TE: 60-120 ms) sequences, with additional gadolinium injection in 3 cases. MRI features were the following: 1) round, patchy lesions with low T 1 signal highlighted by gadolinium and bright T 2 signal were present in 10 of the 11 patients: all osteolytic lesions seen on plain X-rays corresponded to such lesions and biopsy performed in 4 cases showed massive marrow replacement by plasma cells. 2) overall marrow signal was dramatically decreased in 3 patients (2 of whom had a high tumoral mass). 3) extra-dural compression was present in 4 cases. 4) 25 vertebral compression fractures (10 of whom with a "benign" appearance) and focal fat deposition were seen. 5) postradiation treatment examination seemed predictive of the outcome in the 2 solitary plasmacytomas. MRI proved to be more sensitive than plain X-rays or bone scintigraphy. Number and size of focal tumor-like lesions did not correlate with the low marrow signal appearance. Both correlated poorly with overall tumoral mass but diffuse abnormalities were associated with rapidly fatal outcome in three cases. These features might reflect qualitative rather than quantitative patterns of the disease (nodular or diffuse macroscopic marrow replacement). These findings are in agreement with those of the few previous studies. MRI is valuable for spinal cord damage assessment. It appears less accurate in benign versus malignant vertebral compression fracture determination than it does in bone metastasis. Its prognostic value is still questionable.

Aged↗
PubMed1992

Primary extramedullary plasmacytoma of the small intestine.

We report a case of primary extramedullary plasmacytoma (PEMP), IgA kappa type, with a long clinical history, in a 64-year-old Japanese woman. In this case, PEMP occurred primarily in the jejunum and then recurred in several organs, specifically the spleen and stomach, and in the subcutaneous tissue, over a period of about 16 years. However, examination of bone marrow aspirates on several occasions continued to show no plasmacytoma involvement. The patient is still living. Immunohistochemical examinations revealed monoclonal IgA kappa immunoglobulin in the cytoplasm of infiltrating plasma cells in all surgical specimens examined. Immunoelectrophoresis revealed serum M-component only when the patient had a splenic tumor. Soon after splenectomy, the serum M-component disappeared. PEMP of the small intestine is rare.

Female↗
PubMed2003

[A case of jejunal stricture due to extramedullary plasmacytoma].

Extramedullary plasmacytoma is a rare disease in which a neoplastic proliferation of plasma cells originates from the outside of the bone marrow. The jejunum is the most common site of extramedullary plasmacytoma of the gastrointestinal tract and its common complications are intestinal obstruction due to mass, gastrointestinal bleeding, and intussusception. A 68-year-old woman presented with intermittent postprandial abdominal pain, vomiting, and weight loss. Abdomen and pelvis CT revealed diffuse wall thickening of the proximal jejunum. Small bowel series and enteroclysis revealed a short segment stricture of the proximal jejunum. A 2 cm long jejunal stricture was detected on peritoneoscopic surgery. A pathology showed a solid mass beneath the submucosa grossly and malignant plasma cell infiltration microscopically. A immunochemical staining showed monoclonal kappa chain expression. A bone marrow examination showed only mild reactive plasmacytosis. Serum protein electrophoresis, skull and spine X-ray showed no specific abnormality, and urinary Bence Jones protein was negative.

Aged↗
PubMed2003

Solitary extramedullary plasmacytoma of the maxillary sinus. Case report.

Solitary extramedullary plasmacytomas are rare tumors that often affect head and neck region. Because of the non-specific associated symptomatology, they frequently are misdiagnosed. We briefly describe a 69-year-old woman who developed solitary plasmacytoma in the left maxillary sinus and was initially treated as having sinusitis. We also report the diagnostic work-up that is necessary to establish a correct diagnosis in such cases. This case highlights that an appropriate investigation for neoplastic disease should be performed in patients presenting with persistent symptoms that resemble those of sinusitis, especially if these do not resolve after conservative medical treatment.

Aged↗
PubMed2003

[Clinical study of solitary bone plasmacytoma].

OBJECTIVE: To study the clinical characteristics and the prognosis of solitary bone plasmacytoma (SBP). METHODS: From June 1997 to June 2002, ten SBP patients were treated in our department. Two lesions were in sacrum, two in pelvis, the other six lesions were in proximal femur, femoral diaphyseal, scapula, thoracic vertebra, proximal humus, and rib respectively. The preoperative laboratory tests were normal. Operation was performed on all patients. The pathologic diagnose was plasmacytoma and then they underwent further laboratory examination, urine Bence-Jone protein is positive in 3 patients, serous IgG value was higher than normal in 2 patients, abnormal M protein was found in electrophoresis in 2 patients. All patients received radiotherapy postoperatively. RESULTS: Four patients were excluded, whose follow-up were lessen than ten months, the other six patients's average follow-up is 28.2 months (from 18 to 48 months), one patient who developed multiple myeloma (MM) six months postoperatively received chemotherapy using M2 protocol and died 21 months after operation. The other five patients had disease-free survive and remain solitary bone lesion after the treatment of surgery and radiology. CONCLUSION: Compared with MM, SBP patients are younger, the therapeutic results and prognosis are better. The main prognostic factors include age, the size of lesion, the axial bone lesion, persistence of myeloma protein after radiotherapy, early diagnosis and treatment, and so on.

Bone Neoplasms↗
PubMed1977

The allogeneic effect on tumor growth. I. Inhibition of a murine plasmacytoma, MOPC 315, by the graft-vs-host reaction.

The allogeneic effect has been employed as a potent immunopotentiator in preventing the growth of a murine plasmacytoma and prolonging host survival. Parental BALB/c spleen cells were passively transferred to (BALB/c x A/H)F1 hybrid mice, who were then given a highly lethal dose of MOPC 315 plasmacytoma, a tumor of BALB/c origin. The resultant graft-vs-host reaction protected the recipient mice against growth of the tumor and significantly prolonged survival. This phenomenon was dependent upon the dose of BALB/c lymphoid cells employed, the route of administration, and the time interval between lymphoid cell transfer and tumor inoculation. A wide range of lymphoid cell doses and time intervals were effective, and repeated doses of allogeneic cells provided better protection than a single dose.

Animals↗
PubMed1977

The allogeneic effect on tumor growth. II. Suppression of both ascitic and solid MOPC 315 plasmacytoma by the graft-vs-host reaction, with pathologic correlation.

The growth of an ascitic murine plasmacytoma, MOPC 315, can be retarded in CAF1 hybrid host mice by the i.p. injection of donor lymphoid cells. The graft-vs-host reaction can be established by a variety of donor cells, including parental BALB/c and A/J and congenic inbred B10.D2 which share the major histocompatibility locus with BALB/c(H-2d). Optimal results are consistently obtained when parental BALB/c spleen cells are injected before tumor inoculation, and a second dose of donor spleen cells injected 1 week later. This aloogeneic effect on tumor growth is manifested by delayed appearance of the tumor and prolonged host survival. Pathologic studies on the ascites tumor indicated that the allogeneic effect suppresses the initial appearance and early growth of the plasmacytoma. However, once established, MOPC 315 grows rapidly and fatally in both control mice and recipients of donor lymphoid cells. Further, a subcutaneous implant of MOPC 315 is suppressed by an allogeneic effect established either i.v. with BALB/c spleen cells before tumor inoculation or by BALB/c spleen cells administered subcutaneously at the time of MOPC 315 implant. Thirty percent of mice treated by i.v. or subcutaneous donor lymphoid cells were tumor free at 150 days after tumor inoculation.

Animals↗
PubMedDate not supplied

Retro-peritoneal plasmacytoma: a case report and review of literature.

Solitary Extramedullary Plasmacytoma (EMP) is an uncommon neoplasm. When diagnosed, head and neck region is its most likely location. Rarely, it may occur in the retro-peritoneum. We report a 44 year old man with solitary extramedullary plasmacytoma in the retro peritoneum (RPEMP). The patient did not show response to three cycles of VAD chemotherapy. Thereafter Surgical excision of the mass was performed successfully. This is probably the first case report from Indian subcontinent.

Adult↗
PubMed2004

[Extramedullary plasmacytoma of the head and neck].

The aim of this review was to present plasma cell neoplasms, their development, common features and classification. Extramedullary plasmacytoma (EMP) is a most often plasma cell neoplasm in the head and neck. 80-90% EMP cases concern to head and neck: 40% nasal cavity and paranasal sinuses, about 20% nasopharynx, 18% oropharynx. Tumour symptoms are similar like in other neoplasm. It is very important to remember about plasma cell neoplasm during differential diagnosis because of relatively common occurrence. Extramedullary plasmacytoma is radiosensitive neoplasm with good prognosis therefore radiation therapy is the method of choice.

Head and Neck Neoplasms↗
PubMed1992

Gastric extramedullary plasmacytoma in a dog.

A 10-year-old mixed-breed dog was examined because of a 6-week history of daily vomiting and sporadic diarrhea. On gastroscopy, a crateriform mass was observed on the greater curvature of the stomach. Partial gastrectomy and lymphadenectomy of a large mesenteric lymph node was performed. Gastric plasmacytoma with lymph node metastasis was diagnosed by histologic and immunoperoxidase methods, and chemotherapy was initiated with doxorubicin hydrochloride and diphenhydramine hydrochloride. The dog remains clinically normal 30 months after initial diagnosis. Although gastric plasmacytomas are rare in dogs, long-term survival appears to be better with this disease than with other types of gastric neoplasia.

Animals↗