Primary eyelid plasmacytoma

We report a case of eyelid plasmacytoma. The patient presented with a superficial lesion on the upper left eyelid, 10×7 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 κ 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.     

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.     

A rare case of obstructive jaundice secondary to pancreatic plasmacytoma

Pancreatic plasmacytoma is a rare entity & present with features of mass lesion of pancreas. We presented an interesting case of pancreatic plasmacytoma with severe abdominal pain and cholestatic symptoms. This case highlights the importance of considering pancreatic plasmacytoma in differential diagnosis of patients with cholestatic jaundice & abdominal pain and that not all pancreatic head mass are adenocarcinoma, so biopsy is advisable.     

Primary plasmacytoma of testis. Report of a case.

A primary testicular tumour in a 62 year old man was found to be a plasmacytoma on histopathological examination without any extra testicular disease prior to or subsequent to orchiectomy, fulfilling the criteria for the primary extramedullary plasmacytoma. Such cases are extremely rare. Evaluation of such a case was discussed and the relevant literature reviewed.     

Primary isolated extramedullary plasmacytoma of mesentry: A rare case report

Extramedullary plasmacytoma (EMP) is an uncommon entity that most commonly involves nasopharynx and upper repository tract. Involvement of GIT occurs in approximate 10% of cases. According to WHO plasma cell tumors have been classified into two main groups: Multiple myeloma and plasmacytoma. Plasmacytoma includes solitary plasmacytoma of bone and solitary extramedullary plasmacytoma. EMP can be either primary without evidence of bone marrow involvement or may occur simultaneously with multiple myeloma representing extramedullary spread of the disease. It may occur in association with multiple myeloma and it may precede, accompany or follow the onset of multiple myeloma. Diagnosis of primary EMP requires the exclusion of associated multiple myeloma as shown by negative Bence Jones Proteins in urine, normal serum electrophoresis, normal bone marrow biopsy, normal skeletal survey and normal calcium levels. Here we present a case of 55-year male who came to Nephrology Department for urinary tract infection and pain abdomen. Patient was referred to Radiology for ultrasonography which revealed bilateral renal parenchymal disease with a well-defined mass in the mesentry which was further confirmed on computed tomography. Patient was surgically operated and diagnosis of primary EMP of mesentry was made on histopathological examination. Only three cases have been reported so far in the literature. Keywords: Extramedullary plasmacytoma, mesentry, plasma cell dyscrasias.     

Solitary bone plasmacytoma and extramedullary plasmacytoma

Opinion statement Solitary bone and extramedullary plasmacytomas are rare plasma cell proliferative disorders. Their diagnosis is based on histologic confirmation of monoclonal plasma cell infiltration of a single disease site and on the exclusion of systemic myeloma. For both entities, the treatment of choice is localized radiotherapy. With modern radiotherapy and with a total dose of at least 4000 cGy, the risk for local recurrence is less than 5%. There is no role for systemic chemotherapy in the management of these disorders. Approximately 30% of patients with solitary bone plasmacytoma (SBP) remain disease-free for several years; some of these patients may be cured. Patients with the best prognosis are those in whom the monoclonal protein disappears by 1 year after radiotherapy. The prognosis of patients with solitary extramedullary plasmacytoma (SEP) appears to be better than for patients with SBP because approximately 70% of patients with SEP remain disease-free at 10 years. With more sensitive staging procedures, the diagnosis of SBP and SEP may become less common, but the number of patients with prolonged stability and cure may increase.     

Solitary plasmacytoma of bone and extramedullary plasmacytoma

A small proportion of patients with plasma cell myeloma have a solitary plasmacytoma of bone. Strict staging criteria, including normal MR imaging studies of the axial skeleton and the long bones and absence of monoclonal plasma cells detected by flow cytometry or PCR, are required for diagnosis. Radiotherapy at a dose of 4500 cGy is required to eradicate the local tumor. Many patients enjoy prolonged disease-free survival, but the incidence of systemic relapse is high. It is expected, however, that if strict diagnostic criteria are applied some patients may be cured. Extramedullary plasmacytoma is an even rarer plasma cell disease which usually occurs in the head and neck area. Careful microscopic and immunohistochemical studies are required for the correct diagnosis, because this disease can be confused with other malignancies, particularly lymphomas. The treatment of choice is radiotherapy which, in cases of head and neck plasmacytomas, should encompass the adjacent lymph nodes. Most patients with extramedullary plasmacytoma can be cured, and fewer than 30% develop a distant failure in the form of multiple myeloma or multiple extramedullary tumors.     

SOLITARY PLASMACYTOMA OF BONE AND EXTRAMEDULLARY PLASMACYTOMA

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Solitary plasmacytoma

A Retrospective Review Is Presented Of Nine Patients Presenting With Solitary Plasmacytoma. Between 1963 And 1980, These Patients Were Treated With Radiation At The Department Of Radiation Oncology, University Of Louisville. Criteria For Admission To This Particular Study Include (1) A Solitary Focus Of Plasmacytoma Proven By Biopsy, (2) Normal Bone Marrow Findings (Less Than 10% Plasma Cells), And (3) No Evidence Of Disseminated Disease. In Six Patients The Primary Site Was Osseous, And In Three Extramedullary, Two Of Which Were Located In The Nasopharynx And Nasal Cavity And The Third In The Stomach. All Of The Extramedullary Plasmacytomas Are Disease Free For Periods Ranging From 4 To 10 Years. Of The Six Patients With Osseous Lesions, Two Developed Multiple Myeloma In 2 And 3 Years, Two Are Ned (No Evidence Of Disorder) After 9 Years, One Died Of Intercurrent Disease, And The Remaining Patient Was Ned For 2 Years, After Which He Was Lost To Follow-Up. These Results Suggest The More Favorable Prognosis Of Extramedullary Plasmacytoma And Support The Theory That The Solitary Plasmacytoma Of Bone And Extramedullary Plasmacytoma Are Distinct Disease Entities.     

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.     

Extramedullary nasal plasmacytoma

An extremely rare case of Extramedullary Plasmacytoma of nose is reported. The pathogenesis and management discussed.     

Solitary plasmacytoma. I: Extramedullary soft tissue plasmacytoma.

The details of 16 patients with extramedullary plasmacytoma are presented. All but one presented with localized disease, and all were treated successfully by radiotherapy. Only one patient developed local recurrence and only one has developed disseminated disease. Radiotherapy is recommended as the primary treatment of choice for these localized radiosensitive tumors. It is suggested that the good prognosis of plasmacytomas of the head and neck, in contrast to plasmacytomas arising at other sites, is related to the observation that a high proportion of these tumors are localized at the time of diagnosis and that very large primary tumors are uncommon.     

The treatment of solitary plasmacytoma of bone and extramedullary plasmacytoma

Eleven patients with solitary plasmacytoma of bone (SPB) and six patients with extramedullary plasmacytoma (EMP) were treated at the UCLA Center for the Health Sciences. Primary treatment in 14 of 17 patients was with radiation, while three patients were irradiated for recurrent disease. Eleven patients with SPB were irradiated with dose of 32-55 Gy, with 10 of 11 patients receiving doses of 40-55 Gy. Local control was achieved in 10 of 11 patients with SPB. One patient died with metastatic disease with unknown local status. Six patients with EMP were irradiated with doses of 38-56 Gy. Of these patients, two were locally controlled; one patient failed locally; one patient died during treatment; one patient died with local disease at 85 months after multiple resections, chemotherapy, and two courses of irradiation; and one patient was lost to follow-up. Progression to multiple myeloma was seen in 5 of 11 patients with SPB and in none of six patients with EMP. For patients with SPB, we recommend treating the entire bone to 40 Gy, with a boost when feasible. Patients with EMP receive the same dose, including the lymph nodes in tumors at high risk for spread. Radical surgical resections appear to be unwarranted.     

IgM-producing gastric plasmacytoma

A case of gastric plasmacytoma is reported in an 81-year-old woman. Immunofluorescent and immunoelectrophoretic studies showed that the tumor cells produced IgM-lambda molecules, whereas no monoclonal immunoglobulin could be detected both in the serum and in the urine. Of more than 60 reported cases of gastric plasmacytoma, only a few reports referred to the production of monoclonal immunoglobulin by the tumor cells. This case is the first one of IgM-producing gastric plasmacytoma. Moreover, the produced IgM was found to be 7S-IgM. It is extremely rare that 7S-IgM alone is detected in the absence of 19S-IgM.     

Solitary plasmacytoma. II: Solitary plasmacytoma of bone.

The clinical features and the results of treatment of twelve patients with solitary plasmacytoma of bone (SPB) are reported. The median age at presentation was 53 years and there was a predominance of males. Five patients have developed multiple myeloma (MM), for within three years and one after twelve years. Seven patients have not shown evidence of dissemination, and five are alive 1--15 years (median 9 years) after diagnosis. Two patients had metastases to local lymph nodes. There are no reliable criteria by which patients with truly SPB can be prospectively distinguished from those with occult MM, and it is recommended that all patients with apparent SPB should receive "curative" local therapy.     

Localized thyroid plasmacytoma

Two cases of localized thyroid plasmacytoma are described and the literature is reviewed. In most cases the tumors arise in thyroid glands with lymphocytic thyroiditis. Thyroidectomy with regional lymph node biopsy seems to be the initial treatment of choice. Postoperative irradiation appears to be indicated in cases with residual thyroid tissue remaining and in those with documented regional nodal involvement.     

Primary extramedullary plasmacytoma of the small intestine. A case report and review of the literature

A case of primary extramedullary plasmacytoma of the small intestine in a 73-year-old Japanese woman was reported. The patient underwent local resection of the tumor, and showed no signs of local recurrence or dissemination of the disease after 28 months follow-up.The tumor cells had relatively large nuclei with distinct nucleoli and wide and slightly basophilic cytoplasm with a high N/C ratio which showed the morphology of atypical plasma cells. Immunohistochemical examination revealed that the tumor cells contained IgG gamma-type immunoglobulin in their cytoplasm but they did not contain IgA, IgM, IgD, and kappa-light chains. The tumor cells were also positive for CD79a and CD138 and negative for LCA, CD20 and CD45RO. These findings clearly indicated this case to be plasmacytoma.