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PubMed2003

Subcutaneous plasmacytomas with tropism to sites of previous trauma in a multiple myeloma patient treated with an autologous bone marrow transplant.

We report the case of a 59-year-old woman with Durie-Salmon stage IIIB IgGkappa multiple myeloma (MM), who presented 83 days after autologous hematopoietic stem cell transplant (HSCT) with multiple subcutaneous plasmacytomas. These lesions were confined exclusively to sites where the patient had sustained local trauma. The patient had no pre-transplant history of extramedullary disease and no evidence of plasma cells in the peripheral blood at any time throughout the course of her disease. This case represents the first report of refractory MM presenting as multiple subcutaneous plasmacytomas with specific tropism to sites of previous trauma. Selection of tumor cell subclones with unique chemokine receptor expression profiles that may explain this clinical observation is discussed.

Bone Marrow Transplantation↗

PubMed1988

B cell growth and differentiation activity of interleukin-HP1 and related murine plasmacytoma growth factors. Synergy with interleukin 1.

It was recently shown that T cells, macrophages and fibroblasts produce growth factors for B cell hybridomas and plasmacytomas. These factors were subsequently identified as members of a new family of cytokines on the basis of NH2-terminal amino acid sequence analyses. Using T cell-derived interleukin-HP1 (HP1), purified to homogeneity, as the prototype of this family, we examined the effects of these molecules in conventional polyclonal B cell activation assays with anti-immunoglobulin antibodies or dextran sulfate as co-stimulators. In the absence of other cytokines, the only significant effect of HP1 was to stimulate moderately the proliferation of anti-immunoglobulin-activated B cells. By contrast, in conjunction with interleukin 1, HP1 became a major growth and differentiation factor not only for B cells activated with anti-immunoglobulin antibodies but also for dextran sulfate-stimulated and even for unstimulated B cells. In fact, with respect to cell proliferation or IgM synthesis, the IL 1-HP1 combination proved to be equivalent to B cell stimulatory factors like IL 4 or IL 5. This B cell stimulatory activity was not due to the presence of a contaminant in the HP1 preparation because it was also observed with purified plasmacytoma growth factors derived from macrophages and fibroblasts, and could be inhibited by a monoclonal anti-HP1 antibody.

Animals↗

PubMed1986

Inhibition of antibody production from the plasmacytoma cell line MOPC-315 by staphylococcal enterotoxin B-induced T-suppressor cells.

Our previous results have shown that staphylococcal enterotoxin B (SEB) induces a population(s) of T cells which has the capacity to suppress the antibody response of splenocytes in vitro. In the present report we have attempted to investigate the effect of SEB-primed cells on the secretion of antibody by the plasmacytoma cell line MOPC-315. We have found that the secretion of antibody by MOPC-315 is significantly reduced in as little as 24 hr of coculture with the suppressor cells. The suppressive activity is not antigen- or isotype-specific, since the antibody secretion by both MPC-11 and HOPC1 plasmacytomas are also inhibited by the SEB-primed cells. In addition, we have found that the SEB-primed cell population which inhibits the antibody production by the MOPC-315 cell line expresses the Lyt-1+,2- and Thy-1+ cell surface markers. The apparent relationship between the SEB-primed suppressor cell population and the population which inhibits a conventional antibody response is discussed.

Animals↗

PubMed1982

Human plasmacytoma with an unusual karyotype growing in vitro and producing light-chain immunoglobulin.

A new human plasmacytoma line (Karpas 707) was established from the cells of the bone-marrow and peripheral blood of a patient with Bence-Jones-positive multiple myeloma. The cells of this line resembled the patient's malignant cells and fresh myeloma cells from nine other patients in being Epstein-Barr viral nuclear antigen negative. They looked like plasma cells and they secreted only lambda light chains. Both these cells and the patient's fresh cells were hypodiploid and contained the Philadelphia chromosome and several other markers. This line seems to be the first human plasmacytoma line since the IgE lambda-producing line (U266) established in 1968, and it may be suitable for the production of human monoclonal antibodies.

Antibodies, Monoclonal↗

PubMed2003

Congo red-positive cardiac kappa-AL amyloidosis in plasmacytoma -- case report and review of the literature.

We report on a 51-year-old female patient who was diagnosed in 2001 as suffering from plasmacytoma. The patient had had complaints of bilateral carpal tunnel syndrome in 1999, treated by a simple dissection without performing histological examination. Congestive heart failure had gradually developed since that time. In 2001 echocardiography revealed a pronounced thickening of the left ventricular wall with systolic and diastolic dysfunction. A kappa-light chain M component and kappa-light chain-restricted bone marrow plasmacytosis were detected. Amyloid deposits staining positive in the kappa-light chain-restriction analysis were observed in a gastric biopsy. Taking into consideration all these findings, a plasmacytoma-associated systemic AL amyloidosis was diagnosed. Cyclophosphamide/prednisolone chemotherapy regimen led to complete haematological remission. Cardiac transplantation, combined with autologous peripheral blood stem cell graft, was considered as the next therapeutic step, but the patient died while on the waiting list for transplantation. Autopsy detected a highly hypertrophic myocardium with narrowed heart cavities. Microscopic examination revealed dense, pink, acellular, Congo red-staining and kappa-immunoperoxidase-positive AL amyloid masses splitting the cardiomyocytes. The present case is remarkable as it demonstrates that carpal tunnel syndrome and congestive heart failure could be symptoms of plasma cell dyscrasia-associated amyloidoses.

Adult↗

PubMed1983

Extrahepatic biliary tract obstruction due to plasmacytoma.

In multiple myeloma, diffuse infiltration of the liver by myeloma cells can result in hepatic dysfunction and enzyme elevation. Discrete plasmacytomas are unusual and seldom disturb hepatobiliary function. We report a patient who developed jaundice due to extrahepatic biliary obstruction caused by an abdominal plasmacytoma.

Abdominal Neoplasms↗

PubMed1979

Plasmacytomas of the breast: an unusual manifestation of multiple myeloma.

One of the presenting findings of the described patient with multiple myeloma was multiple plasmacytomas of the breast. Mammograms obtained before and after chemotherapy demonstrated the response to drugs. The finding of plasmacytomas of the breast is an unusual manifestation of multiple myeloma.

Breast Neoplasms↗

PubMed1994

Primary cutaneous plasmacytomas.

Primary cutaneous plasmacytoma arising in the skin is very rare. The case of a young man suffering from primary cutaneous plasmacytomas, without an underlying disorder, is reported. The clinical, histopathological, electron microscopical and laboratory findings from the case are described.

Adult↗

PubMedDate not supplied

Extramedullary plasmacytoma. Fine needle aspiration findings.

OBJECTIVE: To determine the role of fine needle aspiration cytology in the diagnosis of extramedullary plasmacytoma. STUDY DESIGN: The study group consisted of 13 patients with palpable masses at various sites. The tumors were aspirated for cytologic study. RESULTS: The smears revealed groups of mature and immature plasma cells at various stages of maturation. Mature plasma cells showed an eccentric nucleus and abundant, deep, basophilic cytoplasm with a paranuclear halo. Plasmablasts (immature plasma cells) showed a prominent, eccentric nucleus with single, large nucleolus and abundant, deep, basophilic cytoplasm with no paranuclear halo. Binucleate and multinucleate forms were also seen quite often. The tumors were excised, and the histologic sections confirmed the cytologic diagnosis. All the patients received radiotherapy. One patient (18 years old) developed recurrence and died due to extensive infiltration into the maxilla and mandible. Two patients (57 and 62 years) developed multiple myeloma one to two years after the excision of tumors, and both died two to three months later. The remaining 10 patients were alive and well at this writing. CONCLUSION: The smears from all 13 patients were diagnosed as extramedullary plasmacytomas by fine needle aspiration cytology.

Adolescent↗

PubMed2001

[A case of myeloma kidney complicated by extramedullary plasmacytoma with massive bleeding].

A 76-year-old woman, who had received hemodialysis due to chronic renal failure of unknown cause for two months, was admitted to our hospital. She was suffering from severe pain in the left thigh, rapidly progressive anemia and thrombocytopenia after receiving a contusion on her left thigh. Soon after admission, the patient died of shock. Autopsy revealed multiple myeloma(lamda type) with extramedullary plasmacytoma and systemic amyloidosis. In the kidney, there were typical tubular casts with multinucleated giant cells and interstitial fibrosis. More specific findings included an extramedullary plasmacytoma in the left iliopsoas muscle surrounded by a huge hematoma. Internal hemorrhage resulting from indirect contusion at this site was likely to have caused her shock. Since typical clinical findings of multiple myeloma, such as serum M protein and hypercalcemia, were not found in this case, it was difficult to make a diagnosis of multiple myeloma. In case of multiple myeloma, micro- or macroscopic extramedullary tumor formation is not rare, but there has been no report of a case with macroscopic tumor formed in skeletal muscle, exhibiting massive hemorrhage. We report here a case of multiple myeloma with an unusual clinical course.

Aged↗

PubMed1990

[Multiple myeloma causing obstructive jaundice by extramedullary plasmacytoma after Bence Jones protein loss--an autopsy case report].

A 63-year-old man was admitted to our hospital with a chief complaint of general malaise in March 1986. A diagnosis of Bence Jones protein (kappa) type of multiple myeloma was made from increased atypical plasma cells in the bone marrow, urinary BJP (kappa) and osteolytic lesions. Urinary BJP (kappa) was decreased by MP and VENP therapies. In April 1987, he visited us again with the complaint of pain on the left shoulder. An examination revealed multiple osteolytic lesions and bilateral pleural effusion containing atypical plasma cells. Jaundice was developed at the end of July 1987. An ultrasound examination revealed a hypoechoic mass in the area of pancreatic head. The effusion was gradually increased without response to the treatment. He died of respiratory failure on July 31, 1987. On autopsy, extramedullary plasmacytoma was found in the head of pancreas. It was a rare case of multiple myeloma in which pleural effusion and multiple plasmacytomas, and finally obstructive jaundice were developed although urinary BJP (kappa) was reduced by treatment.

Bence Jones Protein↗

PubMed1987

Purification and NH2-terminal sequence of a plasmacytoma growth factor derived from the murine macrophage cell line P388D1.

Plasmacytoma growth factor (PCT-GF), a putative macrophage-derived lymphokine essential for the in vitro viability and proliferation of early generation plasmacytomas, was purified from conditioned medium of the murine macrophage cell line P388D1. The purification of PCT-GF was accomplished by a batch concentration on trimethylsilyl-controlled pore glass beads, followed by: gel filtration chromatography; hydrophobic interaction HPLC; and reverse-phase HPLC. SDS-PAGE analysis of the purified PCT-GF revealed a single band of Mr 23,000. The amino terminal sequence of PCT-GF was established as NH2-Pro-Thr-Ser-Gln-Val-Arg-Arg-Gly-Asp-Phe-Thr-Glu-Asp-Thr-Thr-Pro-Asn- Arg-Pro-Val-Tyr-Thr. No significant homology was found between this sequence and proteins in the National Biomedical Research Foundation database, suggesting that PCT-GF is a new lymphokine unrelated to previously described growth and differentiation factors.

Amino Acid Sequence↗

PubMed1995

[Computerized tomography diagnosis of a secondary extramedullary situated, non-secreting plasmacytoma of the right plica ventricularis].

We report the case of a 62-year-old male patient with an extramedullary non-secreting plasmacytoma of the right plica ventricularis. Although his skeletal lesions remained stable, the patient developed hoarseness. This was interpreted as mycotic laryngitis and computed tomography showed a tumor of the right plica ventricularis. Differential diagnosis included neoplasms of the larynx, thyroid gland or a lymphoma. After biopsy, however, histology revealed the rare diagnosis of a secondary extramedullary non-secreting plasmacytoma.

Biopsy, Needle↗

PubMed1995

Avid uptake of technetium-99m-HMPAO by an intracranial plasmacytoma during carotid balloon test occlusion.

A 56-yr-old woman was evaluated for removal of a tumor at the base of the skull. A test to determine the risk of carotid artery sacrifice was performed prior to surgery using carotid balloon occlusion of the left internal carotid artery and 99mTc-HMPAO perfusion scintigraphy during the occlusion. An unusual intense focus of increased uptake was seen at the site of the primary tumor in the left cavernous sinus. The tumor, found to be plasmacytoma at surgery, demonstrated only mild washout from 30 min to 2 hr after administration of 99mTc-HMPAO, with a tumor-to-cerebellum ratio of 1.6 and 1.5, respectively, and a tumor-to-contralateral cranial ratio of 2.5 and 2.4, respectively. Intracranial plasmacytoma shows good response to radiation therapy, and the differentiation of this tumor from other neoplasms is pertinent to the mode of treatment and surgical approach. Technetium-99m-HMPAO SPECT imaging may be a useful tool in distinguishing these tumors from other neoplasms at the base of the skull.

Brain Neoplasms↗

PubMed1997

[Plasma cell leukemia with amyloid deposition and osteogenetic change at the site of an extramedullary plasmacytoma].

A 49-year-old man was admitted with swelling in the left lower extremity, and a mass in the left lower abdomen. Laboratory findings showed an increased WBC of 15,000/microliter with 41% plasma cells, and immunoglobulin (Ig) A of 2,557mg/dl with a monoclonal component. A roentgenogram and computed tomograph of the abdomen revealed that a 5 x 10 cm mass with calcification located in the iliopsoas muscle. Plasma cell leukemia with extramedullary plasmacytoma was diagnosed, and the patient was treated with high-dose dexamethasone (40 mg/day for 4 days), resulting in a good response with the disappearance of plasma cells in peripheral blood and a marked decrease in serum Ig A. However, the patient's condition deteriorated in spite of various treatments, and he died of heart failure 5 months after admission. With informed consent from relatives, a necropsy was performed and infiltration of plasma cells in the mass in the iliopsoas muscle was noted. We reported this case because plasma cell leukemia with amyloid deposition and osteogenesis at the site of extramedullary plasmacytoma is very rare.

Amyloid↗

PubMed1982

Intracranial solitary extraskeletal plasmacytoma resembling meningioma.

A patient had an intracranial solitary extraskeletal plasmacytoma (SEP). To date, only 12 similar cases have been reported in the English literature. This report includes the first description of computed tomographic findings in a patient with intracranial SEP. There is a striking similarity between the features of intracranial SEP and meningiomas. A detailed comparative study of the features of these two neoplasms was done. The findings indicate that the age and sex distribution, clinical features, location of the tumors, roentgenographic findings, and even the gross pathologic nature of the two neoplasms are very similar. The course and prognosis, however, are probably different. Intracranial SEP, although rare, should be included in the differential diagnosis of brain tumors that arise in areas where meningiomas commonly arise.

Adult↗

PubMed1982

Immunoperoxidase characterization of pharyngeal plasmacytoma.

Extramedullary plasmacytomas (EMPs) are plasma cell neoplasms that most frequently arise along the upper airways and often do not secrete detectable amounts of M protein at the time of diagnosis. The present report describes the immunohistochemical characterization of an EMP in a young woman. The unlabeled peroxidase-antiperoxidase method was employed to demonstrate cytoplasmic immunoglobulin determinants in routinely processed, paraffin-embedded tissue. Only kappa light chain and lambda heavy chain determinants were found in the cytoplasm of the neoplastic plasma cells; essentially identical results were found in both initial and recurrent lesions separated by a 16-month interval. This exclusive staining of one light chain type associated with only one heavy chain represents a monoclonal staining pattern that is typical of B-cell neoplasms. Such characterization of EMPs on the basis of cytoplasmic immunoglobulin class and type may provide prognostic information analogous to the classification of multiple myeloma by immunoelectrophoresis.

Adenoids↗

PubMed1994

Solitary plasmacytoma of the mastoid bone presenting as coalescent mastoiditis.

Acute mastoiditis is a complication of acute otitis media that produces air cell opacification and coalescence on computed tomographic (CT) imaging. This appearance, however, is nonspecific and may be seen in patients with infection and tumor. Magnetic resonance imaging (MRI) can aid in differentiating the two on the basis of differences in tissue signal characteristics and by showing the presence or absence of an associated soft-tissue mass. In this report, we demonstrate the utility of MRI as a complementary imaging modality to CT in the diagnosis of a solitary plasmacytoma of the temporal bone that was initially thought to be coalescent mastoiditis.

Biopsy↗