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PubMedDate not supplied

A therapeutic strategy for isolated plasmacytoma of bone.

Two cases of solitary plasmacytoma of bone (SPB) were diagnosed. The first case was a 41-year-old woman, complaining of fatigue from her lumbar region to her legs. The second case was a 56-year-old man complaining of poor gait and severe lumbago with numbness in the toes of both feet. Magnetic resonance imaging showed the osteolytic lesion in the 12th thoracic bone in the first patient and around the 2nd, 3rd and 4th lumbar bones in the second patient. In both patients serum analysis revealed the monoclonal component of immunoglobulin G (IgG) protein with kappa-light chain, and considering this and other findings SPB was diagnosed. Both patients were first treated with irradiation around the involved bone and then with a course of chemotherapy. In the first patient the tumour region of the bone was surgically removed and replaced with a ceramic spacer. The symptoms of both patients were ameliorated, and the patients remained in good condition for around 3 years without conversion to multiple myeloma. In view of the overall effectiveness of treatments for SPB, our therapeutic strategy deserves careful evaluation.

Adult↗
PubMed2005

Solitary bone and extramedullary plasmacytoma.

Less than 5% of patients with a plasma cell dyscrasia present with a single bone (SBP) or extramedullary plasmacytoma (EMP) without evidence of systemic disease (normocalcemia, absence of anemia, preservation of uninvolved immunoglobulins, or renal disease attributable to myeloma). Diagnosis requires biopsy confirmation of a monoclonal plasma cell infiltrate from a single site. The treatment of choice for both entities is radiotherapy given with curative intent (> 4000 cGy) resulting in long term disease-free survival in approximately 30% of patients with SBP and 65% of patients with EMP.

Biomarkers↗
PubMed2006

Immunoglobulin free light chains and solitary plasmacytoma of bone.

An abnormal serum immunoglobulin free light chain (FLC) ratio at diagnosis may identify risk of progression to myeloma in patients with solitary bone plasmacytoma (SBP). In the cohort of 116 patients, 43 have progressed to myeloma, with a median time to progression of 1.8 years. The FLC ratio was determined in all 116 patients on serum collected at time of diagnosis and was abnormal in 54 patients (47%). An abnormal FLC ratio was associated with a higher risk of progression to myeloma (P = .039). The risk of progression at 5 years was 44% in patients with an abnormal serum FLC ratio at diagnosis compared with 26% in those with a normal FLC ratio. One to 2 years following diagnosis, a persistent serum M protein level of 5 g/L (0.5 g/dL) or higher was an additional risk factor for progression. A risk stratification model was constructed using the 2 variables of FLC ratio and M protein level: patients with a normal FLC ratio at baseline and M protein level less than 5 g/L (0.5 g/dL) at 1 to 2 years following diagnosis (low risk, n = 31); with either risk factor abnormal (intermediate risk, n = 26); and with both an abnormal FLC ratio and M protein level of 5 g/L (0.5 g/dL) or higher (high risk, n = 18). The corresponding progression rates at 5 years were significantly different in the low, intermediate, and high groups: 13%, 26%, and 62%, respectively (P < .001).

Adult↗
PubMed2002

Immunization against murine multiple myeloma with fusions of dendritic and plasmacytoma cells is potentiated by interleukin 12.

Fusions of cancer cells and dendritic cells (DCs) are effective in the treatment of animal tumor models and patients with metastatic renal carcinoma. In this study, we have fused DCs with mouse 4TOO plasmacytoma cells. The results demonstrate that vaccination of mice with the fusion cells (FC/4TOO) is associated with induction of antitumor humoral and cytotoxic T lymphocyte (CTL) responses. Immunization with FC/4TOO cells protected mice against tumor challenge. In addition, treatment of established multiple myeloma with FC/4TOO cells was associated with prolongation of survival but not with eradication of disease. As interleukin (IL)-12 potentiates the induction of immune responses, recombinant mouse IL-12 was administered with the FC/4TOO vaccine. Treatment of mice with FC/4TOO and IL-12 was associated with increased CTL activity and T-cell proliferation responses. Treatment with FC/4TOO and IL-12 also resulted in eradication of established disease. These findings demonstrate that immunization with FC/4TOO fusion cells and IL-12 potentiates antitumor immunity and the treatment of murine multiple myeloma.

Animals↗
PubMed2006

Prognostic factors in solitary plasmacytoma of the bone: a multicenter Rare Cancer Network study.

BACKGROUND: Solitary plasmacytoma (SP) of the bone is a rare plasma-cell neoplasm. There are no conclusive data in the literature on the optimal radiation therapy (RT) dose in SP. Therefore, in this large retrospective study, we wanted to assess the outcome, prognostic factors, and the optimal RT dose in patients with SP. METHODS: Data from 206 patients with bone SP without evidence of multiple myeloma (MM) were collected. Histopathological diagnosis was obtained for all patients. The majority (n = 169) of the patients received RT alone; 32 chemotherapy and RT, and 5 surgery. Median follow-up was 54 months (7-245). RESULTS: Five-year overall survival, disease-free survival (DFS), and local control was 70%, 46%, and 88%; respectively. Median time to MM development was 21 months (2-135) with a 5-year probability of 51%. In multivariate analyses, favorable factors were younger age and tumor size < 5 cm for survival; younger age for DFS; anatomic localization (vertebra vs. other) for local control. Older age was the only predictor for MM. There was no dose-response relationship for doses 30 Gy or higher, even for larger tumors. CONCLUSION: Younger patients, especially those with vertebral localization have the best outcome when treated with moderate-dose RT. Progression to MM remains the main problem. Further investigation should focus on adjuvant chemotherapy and/or novel therapeutic agents.

Actuarial Analysis↗
PubMed1992

Curability of solitary bone plasmacytoma.

PURPOSE: The effects of involved-field radiotherapy were assessed in patients with a solitary plasmacytoma of bone (SBP). PATIENTS AND METHODS: Forty-five consecutive patients with an SBP received megavoltage irradiation of at least 3,000 cGy. The median age was 53 years, 67% of patients showed a myeloma protein, and uninvolved immunoglobulins (Igs) were preserved in 93% of patients. RESULTS: Permanent control of presenting disease was achieved in all but two patients, but 46% of patients developed multiple myeloma. When it occurred, progression of myeloma occurred within 3 years in two thirds of the patients, suggesting that the extent of disease was understaged at diagnosis. Myeloma protein disappeared in nine patients (30%) whose disease has not yet recurred. The median survival for all patients was 13 years and the myeloma-specific survival fraction at 10 years was 53%. CONCLUSION: In patients with an SBP, the disappearance of myeloma protein with involved-field radiotherapy predicted long-term disease-free survival and possible cure. Nonsecretory disease and persistent myeloma protein after treatment were adverse prognostic factors for which adjuvant therapy with interferon alfa should be considered.

Adult↗
PubMed1993

Magnetic resonance imaging in the staging of solitary plasmacytoma of bone.

PURPOSE: To assess prospectively the role of magnetic resonance (MR) imaging in the staging of patients with a solitary bone plasmacytoma (SBP). PATIENTS AND METHODS: Twelve consecutive patients with an apparent SBP underwent MR imaging of both the primary tumor and the thoracic and lumbosacral spine to seek additional foci of marrow involvement that might have been undetected by standard skeletal survey. All patients received megavoltage irradiation (total dose, 40 Gy) to the primary lesion. RESULTS: MR imaging of the thoracic and lumbosacral spine showed additional foci of marrow replacement in four of 12 patients, with signal characteristics identical to those of the primary tumor. In all four patients, the abnormal protein persisted at greater than 50% of the pretreatment value following radiation treatment. In contrast, the myeloma protein disappeared or was reduced by greater than 50% in five of the six patients with secretory disease and without additional marrow abnormalities. One of four patients progressed to multiple myeloma 10 months after diagnosis with new lesions on conventional radiographs in the same areas as detected previously by MR imaging. CONCLUSION: Four of 12 patients considered to have a SBP by standard criteria may have been understaged, because MR imaging showed additional marrow abnormalities consistent with myeloma. MR imaging of the spine may contribute to the initial staging of SBP, especially since some patients may be cured with radiotherapy.

Adult↗
PubMed1991

Resinless section immunogold electron microscopy of karyo-cytoskeletal frameworks of eukaryotic cells cultured in vitro. Absence of a salt-stable nuclear matrix from mouse plasmacytoma MPC-11 cells.

The karyo-cytoskeleton of cells cultured in vitro was investigated employing resinless section immunogold electron microscopy. Cells were entrapped in low-melting agarose, sequentially extracted with various buffers and digested with nucleases to obtain karyo-cytoskeletal frameworks and reacted with specific primary and gold-conjugated secondary antibodies or gold-conjugated protein A to decorate structural elements of these frameworks. Following embedment of the gold-labeled residual cell structures in diethylene glycol distearate and their sectioning, the embedding material was removed with organic solvent and the sections were finally subjected to CO2 critical point drying. When this technique was applied to mouse skin fibroblasts (MSF), it revealed a dense and salt-stable intranuclear network of fibrogranular material. Antibodies directed against vimentin and lamin B detected a cytoplasmic meshwork of intermediate filaments (IFs) and a nuclear lamina, respectively; the latter, however, only after removal of chromatin from nuclei by nuclease digestion of DNA. Intranuclear filaments free of adhering globular material were morphologically very similar to cytoplasmic vimentin filaments. By contrast, mouse plasmacytoma MPC-11 cells lacking detectable amounts of cytoplasmic IF proteins and lamins A and C were devoid of a salt-stable internal nuclear matrix. The same holds true for MPC-11 cells that had been treated with the phorbol ester 12-O-tetradecanoylphorbol-13-acetate to induce vimentin synthesis and establish a cytoplasmically extended IF network. These findings were in accordance with the biochemical behavior of Triton X-100-treated MSF and MPC-11 cells and their appearance in immunofluorescence microscopy upon extraction with high ionic strength buffer. While the chromatin was quantitatively retained in the residual cell structures derived from MSF cells, in those obtained from MPC-11 cells the nuclear lamina was disrupted and the chromatin was released from the nuclei, suggesting that MPC-11 cells lack the salt-stable nuclear scaffold to which chromatin is normally anchored.

Animals↗
PubMed2000

Isolated extramedullary plasmacytoma of the true vocal fold.

We report a rare case of isolated extramedullary plasmacytoma (EMP) of the right true vocal fold in a 38-year-old male with a one-year history of hoarseness. Immunohistochemical staining of plasma cells in the tumour, showed over 90 per cent of them to be positive for kappa light chains. After two attempts at local surgical excision and recurrence within 10 months, the tumour was irradiated. Only seven reported cases of isolated EMP of the true vocal fold are reported in the literature. The therapeutic options are discussed.

Adult↗
PubMed2003

Definitive radiotherapy for extramedullary plasmacytomas of the head and neck.

Extramedullary plasmacytoma of the head and neck region (EMPHN) is an uncommon malignant plasma cell neoplasm. In this study we conducted a retrospective analysis of our experience of EMPHN with particular emphasis on the role of definitive radiotherapy. From 1982 to 2001, 10 patients (6 males, 4 females) with EMPHN were treated in our institution. Of nine patients treated at initial diagnosis, all received definitive radiotherapy. One patient treated at relapse underwent surgical resection followed by post-operative radiotherapy. The median age at diagnosis was 55 years (range 35-84 years). The disease was most frequently localized in the paranasal sinuses (50%). All nine patients who received definitive radiotherapy at a dose of 40-50 Gy achieved a complete response. The median follow up period was 29 months (range 7-67 months). Four patients (40%) relapsed, three have died of their disease. Two patients (20%) with paranasal sinus disease subsequently relapsed with multiple myeloma at 10 months and 24 months, respectively. Our results indicate that treatment of EMPHN with radiotherapy achieves excellent rates of local control. The relapse rate in neck nodes of 10% does not justify elective irradiation of the uninvolved neck.

Adult↗
PubMed1981

Plasmacytoma arising in the vicinity of a foreign body in the nasal cavity.

The development of a plasmacytoma in the vicinity of a long residing metallic foreign body in the nasal cavity is presented. In spite of the multitude of reports concerning neoplasma associated with trauma, most of which arise in chronic scars, this presentation is very rare. It is speculated that the plasma cell proliferation, occurring nearby the foreign body, roots from an immunologic and granulomatous reaction. This case is discussed in light of the vast data on foreign body tumorigenesis obtained from laboratory animals, and the implications of this data are outlined. Further attention should be drawn to the clinical associations of malignant processes co-existing with long-standing foreign bodies.

Aged↗
PubMed1999

Prognostic value of histopathological grading in canine extramedullary plasmacytomas.

The canine extramedullary plasmacytoma (cEMP) has recently been the subject of numerous investigations, indicating that the histomorphologic diagnosis is often difficult because of the variety of morphologic features. Therefore, the objective of this study was to establish a subclassification scheme for cEMPs and to evaluate correlations between the types and malignancy. Retrospectively, 117 cEMPs, all immunohistochemically characterized by a monoclonal immunoglobulin light-chain expression, were collected and assigned to morphologic types. These types were compared using data from a follow-up study on metastasis and tumor recurrence, then compared by proliferation rate, determined by immunohistochemical detection of the antigen Ki-67. Histopathologic typing revealed five different types of cEMPs, ranging from the mature type with typical plasma cells to the polymorphous-blastic type. Between these two forms, three additional types were established: hyaline, cleaved, and asynchronous. Most of the cEMPs were of the cleaved and asynchronous types. In all cEMPs, mononuclear and multinuclear giant cells were present to varying degrees. Although the results of cell proliferation and the follow-up study indicated less benign behavior by the polymorphous-blastic type, the proliferation rate revealed no statistically significant differences among the cEMP types. The clinical data therefore confirmed previous findings that the risk of tumor recurrence and metastasis in general can be classed as low. The established cEMP typing system is probably a very helpful diagnostic tool, although the types cannot be used for a tumor grading system.

Animals↗
PubMed2005

Extramedullary plasmacytoma of the salivary gland in two Syrian hamsters (Mesocricetus auratus).

Two Syrian hamsters developed marked swelling of the ventral neck. Histologic examination of both masses revealed that the submaxillary salivary glands were effaced by large numbers of neoplastic plasma cells. In one hamster, neoplastic cells had infiltrated the adjacent lymph node. The neoplastic cells expressed CD79a antigen and were negative for CD3, lambda, and kappa light chains. Ultrastructural features of neoplastic cells in the salivary gland of one hamster included abundant cytoplasmic rough endoplasmic reticulum profiles, and peripherally displaced nuclei that contained marginated heterochromatin, consistent with plasma cells. Salivary gland plasmacytomas are extremely rare in humans and have not previously been reported in nonhuman species. The occurrence of such neoplasms in two hamsters suggests that this species may be predisposed to developing tumors of this type.

Animals↗
PubMed2005

Plasmacytoma of the lung: an indolent disease resistant to conventional myeloma treatment: report of a case.

Solitary lung plasmacytoma is a rare form of plasma cell tumors. The case of a 56-yr-old man is presented, who had a massive tumor of the right pulmonary apex. Percutaneous transthoracic lung biopsy demonstrated a tumor-cell population consisting of mature plasma cells, proplasmacytes, and rare plasmablasts. Immunohistochemically, the cells were CD79a+, kappa+, cyclin D1-, p53-, MDR-. Proliferative index was low (number of Ki-67+ tumor cells was 8%). Serum and urine immunoelectrophoresis did not show the presence of paraprotein. Screening for multiple myeloma with skeletal X-ray survey and bone marrow biopsy were negative. Radiotherapy and chemotherapy with alkylating agents were ineffective. However, the course of the disease is indolent and the patient is well, alive, and with no signs of multiple myeloma >5 yr after the diagnosis was established. Some pathogenetic aspects of tumor resistance to conventional myeloma treatment in this case are discussed.

Drug Resistance, Neoplasm↗
PubMed1989

[Primary plasmacytoma of the thyroid--report of an autopsy case and review of the literature in Japan].

Primary extramedullary plasmacytoma (PEMP) of the thyroid is rare. Only nine patients with PEMP of the thyroid have been reported in Japan to date. We describe an additional autopsy case with PEMP of the thyroid and review of the literature in Japan. A 67-year-old women complaining of swelling of the anterior neck exhibited thin scalp hair, edematous face and a giant, hard, nodular goiter. Laboratory examination showed elevated levels of ESR, collagenous reaction, gammaglobulin, and a M-bow of the IgG-k type in immunoelectrophoresis. No Bence-Jones protein was found in the urine. Thyroid function test revealed a subclinically hypothyroid state, showing a T3 of 1.32 ng/ml, a T4 of 10.0 micrograms/dl, a TSH of 23.4 microU/ml and positive thyroid antibodies. The scintigram and the CT scan of the thyroid showed deviation of the trachea by the thyroid tumor and calcification within homogeneous thyroid gland. She underwent total thyroidectomy because of suspected malignancy. The histological examination of the removed thyroid weighing 117gr revealed a proliferation of plasma cells and lymphocytes and small amounts of atrophied thyroid follicles. The immunohistological examination of the removed thyroid showed the monoclonality to IgG-k chain. Plasma cells were stainable with methylgreenpyronine. Twenty-six months after thyroidectomy, she died due to progressive emaciation, anemia, hypoalbuminemia and ascites. Postmortem examination revealed widespread metastasized plasma cell tumors in the liver, intestine, spleen and mesentery with ischemic changes in heart and kidney. Based on our autopsy case and the nine cases reported in Japan, clinical and histological characteristics of PEMP of the thyroid were discussed.

Aged↗
PubMed1985

Extramedullary plasmacytoma of the thyroid gland producing gamma heavy chain.

We encountered a 65-year-old man with gamma heavy chain disease associated with extramedullary plasmacytoma of the thyroid gland. Serum electrophoresis revealed an abnormal fast gamma band that cross-reacted with anti-IgG (Fc gamma) sera immunoelectrophoretically. Intracytoplasmic monoclonal immunoglobulin, IgG (Fc gamma), was demonstrated in thyroid tissue sections using an indirect immunofluorescence method. After surgery, the serum abnormal fast gamma band disappeared. At the time of writing, the patient has survived 18 months post-surgery.

Aged↗
PubMed2005

Plasmacytoma of the urinary bladder in a renal transplant recipient.

A 28-year-old woman underwent renal transplantation in 1993. Eight years later, she experienced macroscopic hematuria, and Epstein-Barr virus-negative solitary extramedullary plasmacytoma (EMP) of the urinary bladder was diagnosed. After the reduction of immunosuppressive therapy, she received combined chemotherapy, resulting in complete tumor disappearance. However, 10 months later, she relapsed with aggressive multiple EMP and died of disease progression in 2003. This report is the first of a case of solitary EMP of the urinary bladder appearing as posttransplantation plasma cell dyscrasias after renal transplantation.

Adult↗
PubMed1985

Extramedullary plasmacytoma of the parotid gland: report of a case and review of the literature.

A case of primary extramedullary plasmacytoma (PEMP) with local amyloid deposition arising in the left parotid gland of a 78-year-old woman is described. The present case was studied with immunologic techniques with results confirming that the neoplastic cells were of monoclonal nature, producing lambda-light chains alone. PEMPs of the salivary glands are rare, with only 8 cases reported in the literature. The salient features of these 9 cases are summarized. Problems connected with the clinical, pathological and therapeutic aspects of PEMP with regard to the rare parotid location are discussed.

Adult↗