-
Cureus Feb 2024Pancreatic ductal adenocarcinoma (PDAC) is a formidable global health concern with a dire prognosis, highlighting the critical need for early detection strategies. This... (Review)
Review
Pancreatic ductal adenocarcinoma (PDAC) is a formidable global health concern with a dire prognosis, highlighting the critical need for early detection strategies. This systematic review delves into the potential of salivary biomarkers as a non-invasive means for identifying PDAC at its incipient stages. Saliva's proximity to the circulatory system enables the detection of tumor-derived biomolecules, making it an ideal candidate for mass screening. The analysis of three selected studies reveals promising candidates such as Neisseria mucosa, Fusobacterium periodonticum, polyamines, and specific long non-coding RNAs (lncRNAs). Notably, polyamines like spermine show potential in distinguishing PDAC, while lncRNAs HOX transcript antisense RNA (HOTAIR) and plasmacytoma variant translocation 1 (PVT1) exhibit superior sensitivity and specificity compared to traditional serum markers. However, challenges, including small sample sizes and a lack of validation, underscore the need for standardized diagnostic panels and large-scale collaborative studies. Advancements in nanotechnology, machine learning, and ethical considerations are crucial for harnessing the diagnostic potential of saliva. The review emphasizes the imperative for extensive clinical trials to validate salivary biomarkers, ensuring not only diagnostic accuracy but also cost-effectiveness, patient compliance, and long-term benefits in the realm of PDAC screening. Longitudinal studies are recommended to unravel temporal changes in salivary biomarkers, shedding light on disease progression and treatment response.
PubMed: 38550499
DOI: 10.7759/cureus.55003 -
Journal of Medical Case Reports Sep 2023Plasmacytoma, a localized tumor of monoclonal plasma cells without any clinical, radiological or physical evidence of plasma cell neoplasm (PCN), is a rare entity that...
INTRODUCTION
Plasmacytoma, a localized tumor of monoclonal plasma cells without any clinical, radiological or physical evidence of plasma cell neoplasm (PCN), is a rare entity that accounts for 1% of PCN. Immunoglobulin M (IgM) extramedullary plasmacytoma of mediastinal region has never been reported and is a diagnostic challenge considering other differential diagnoses.
CASE PRESENTATION
We present the case of a 51-year-old African-American female with progressively increasing cough, dyspnea, and dysphagia for 6 months with a computed tomography (CT) scan revealing a subcarinal mass. The histopathological analysis of the mass reveals a diagnosis of lymphoma with plasma cell differentiation, with a differential of lymphoplasmacytic lymphoma and plasma cell neoplasm. The lymphoma panel via next-generation sequencing (NGS) and a myeloma-targeted fluorescent in situ hybridization (FISH) panel confirmed the diagnosis of IgM extramedullary plasmacytoma, an entity of rare occurrence. Treatment with radiation led to complete regression of the plasmacytoma with normal blood work-up.
CONCLUSIONS
This report describes the challenges of diagnosing IgM extramedullary plasmactyoma. Our case report highlights the importance of cytogenetics and NGS in establishing a correct diagnosis that indeed has prognostic and therapeutic implications.
Topics: Female; Humans; Middle Aged; Plasmacytoma; In Situ Hybridization, Fluorescence; Waldenstrom Macroglobulinemia; Immunoglobulin M; Cell Differentiation
PubMed: 37749639
DOI: 10.1186/s13256-023-04082-x -
Hematology Reports Jan 2024Plasmacytoma is a neoplastic disorder originating from plasma cells, with bone and soft tissue being common sites of manifestation. This report presents the clinical and...
Plasmacytoma is a neoplastic disorder originating from plasma cells, with bone and soft tissue being common sites of manifestation. This report presents the clinical and radiological findings of a 65-year-old female patient who presented with an exophytic lesion in the upper right lateral incisor region. The lesion appeared as a unilocular radiotransparent area in imaging tests. Following an excisional biopsy, histological and immunohistochemical evaluations confirmed the presence of mature plasmacellular elements and small infiltrates of B and T lymphocytes. The patient did not exhibit systemic manifestations of multiple myeloma. Surgical intervention, in the form of enucleation of the lesion combined with root canal treatment and apicoectomy, was performed. This case underscores the rare occurrence of plasmacytoma in the jaw region and highlights the importance of surgical management in cases where structural damage or functional impairment is present. Further research on novel treatment approaches is also mentioned, including targeted therapies, immunomodulatory agents, and monoclonal antibodies. The patient is currently under the care of a hematologist for further investigation and the choice of the most appropriate therapy.
PubMed: 38247993
DOI: 10.3390/hematolrep16010003 -
Cureus Dec 2023Renal plasmacytoma is a rare extramedullary manifestation of plasma cell neoplasms (PCN). We present the case of a 62-year-old male with a history of relapsed refractory...
Renal plasmacytoma is a rare extramedullary manifestation of plasma cell neoplasms (PCN). We present the case of a 62-year-old male with a history of relapsed refractory multiple myeloma (MM) who developed secondary renal plasmacytoma after an eight-year remission period. Radiological findings on plain CT raised concern for the most common renal malignancy, i.e. renal cell carcinoma (RCC), while further imagining evaluation with MRI suggested renal lymphoma, highlighting the diagnostic challenge of renal plasmacytoma on imagining. A renal mass biopsy confirmed a kappa-restricted plasma cell tumor, emphasizing the need for accurate differentiation between renal plasmacytoma and other renal malignancies to guide appropriate treatment strategies. Increased awareness of such cases can lead to timely recognition and tailored management for this rare entity.
PubMed: 38196426
DOI: 10.7759/cureus.50269 -
Heliyon Jan 2024Human trabecular meshwork cell (HTMC) dysfunction results in imbalanced aqueous humor inflow and outflow, leading to an increase in intraocular pressure (IOP)....
PURPOSE
Human trabecular meshwork cell (HTMC) dysfunction results in imbalanced aqueous humor inflow and outflow, leading to an increase in intraocular pressure (IOP). Uncontrolled high IOP can promote the occurrence of glaucoma, an irreversible optic neuropathy. Here, we explored whether the long non-coding RNA plasmacytoma variant translocation 1 (lncRNA PVT1)/microRNA-29a-3p (miR-29a-3p) axis could ameliorate HTMC dysfunction under oxidative stress by modulating the expression of the proangiogenic factor vascular endothelial growth factor (VEGFA) and the profibrotic factor metalloproteinase-2 (MMP-2).
METHODS
HTMCs were cultured under HO-induced oxidative stress for 48 h. The expression of lncRNA PVT1, miR-29a-3p, VEGFA, MMP-2, intracellular adhesion molecule-1 (ICAM-1), and alpha-smooth muscle actin (α-SMA) was detected by reverse transcription quantitative real-time polymerase chain reaction, western blotting, and immunofluorescence. Interference experiments were conducted the transfection of HTMCs with small interfering RNA (siRNA) targeting lncRNA PVT1 or miR-29a-3p mimics. A luciferase reporter assay was undertaken to identify the presence of a miR-29a-3p binding site in lncRNA PVT1. Flow cytometry and Transwell and Cell Counting Kit-8 assays were employed to evaluate HTMC functions under oxidative stress with different treatments.
RESULTS
In HTMCs, the expression of lncRNA PVT1 was induced by HO treatment, whereas that of miR-29a-3p was inhibited. The levels of angiogenic factors (VEGFA, ICAM-1) and fibrosis-associated mediators (MMP-2, α-SMA) were upregulated in HTMCs under oxidative stress. The siRNA-mediated suppression of lncRNA PVT1 or the upregulation of miR-29a-3p significantly suppressed the expression of VEGFA, MMP-2, ICAM-1, and α-SMA. A luciferase reporter assay confirmed that lncRNA PVT1 directly targeted miR-29a-3p and acted as a miR-29a-3p sponge. The knockdown of lncRNA PVT1 restored the level of miR-29a-3p in HO-treated HTMCs, thereby inhibiting VEGFA and MMP-2, its target mRNAs. HTMC dysfunction, including increased apoptosis and decreased cell mobility and viability, could be effectively ameliorated by lncRNA PVT1 downregulation or miR-29a-3p overexpression under oxidative stress.
CONCLUSION
LncRNA PVT1 has potential as a therapeutic target for inhibiting VEGFA and MMP-2, thus protecting HTMCs, suppressing the progression of fibrosis, and, consequently, improving the outcome of glaucoma filtration surgery.
PubMed: 38173510
DOI: 10.1016/j.heliyon.2023.e23607 -
World Journal of Clinical Cases Aug 2023Multiple myeloma (MM) is a common hematologic malignancy that originates from a malignant clone of plasma cells. Solitary plasmacytoma, history of diabetes, and platelet...
BACKGROUND
Multiple myeloma (MM) is a common hematologic malignancy that originates from a malignant clone of plasma cells. Solitary plasmacytoma, history of diabetes, and platelet count are considered as prognostic factors for MM. But some patients are still associated with much worse outcomes without any prognostic predictors. This study aimed to observe the reduction rate of monoclonal protein (M protein) after the first and fourth chemotherapy cycles, which is considered as a new prognostic factor for progression-free survival (PFS) in standard-risk group of newly diagnosed MM patients.
AIM
To investigate the reduction rate of M protein after first and fourth cycle chemotherapy as a useful prognostic factor.
METHODS
A total of 316 patients diagnosed with MM for the first time between 2010 and 2019 at the Lishui Municipal Central Hospital were included. All patients were diagnosed according to the National Comprehensive Cancer Network (NCCN) 2020.V1 diagnostic criteria. The risk assessment was performed by the Mayo Stratification for Macroglobulinemia and Risk-Adapted Therapy guidelines. After diagnosis, 164 patients were evaluated and underwent treatment with four to eight courses of continuous induction chemotherapy. The patients with no response after induction treatment were administered additional therapy following the NCCN 2020.V1 criteria. The following baseline data from the patients were collected: Gender, age at diagnosis, Durie-Salmon stage, glutamic-pyruvic transaminase, glutamic-oxaloacetic transaminase, catabolite activator protein, albumin/globulin ratio, lactate dehydrogenase, translocation (t)(6;14), t(11;14), maintenance regimen, total cholesterol (TC), triglyceride, and phosphorous. All baseline data and the reduction rate of M protein after each chemotherapy cycle from the first to fourth were assessed by univariate analysis. The factors influencing the overall survival and PFS were then assessed by multivariate analysis. We found the first cycle (C1) reduction rate and the fourth cycle (C4) reduction rate as predictors of PFS. Then, PFS was compared between patients with a C1 reduction rate of M protein of ≥ 25% < 25% and ≥ 50% < 50%, and between patients with a C4 reduction rate of ≥ 25% < 25%, ≥ 50% < 50%, and ≥ 75% < 75%.
RESULTS
Multivariate analysis revealed age [hazard ratio (HR): 1.059, 95% confidence interval (95%CI): 1.033-1.085, ≤ 0.001], International Staging System stage (HR: 2.136, 95%CI: 1.500-3.041, ≤ 0.001), autotransplantion (HR: 0.201, 95%CI: 0.069-0.583, = 0.019), TC (HR: 0.689, 95%CI: 0.533-0.891, = 0.019), C1 reduction rate (HR: 0474, 95%CI: 0.293-0.767, = 0.019), and C4 reduction rate (HR: 0.254, 95%CI: 0.139-0.463, = 0.019) as predictors of PFS. The Kaplan-Meier survival analysis and the log-rank tests revealed that a higher reduction rate of M protein after first cycle (≥ 50%) and fourth cycle (≥ 75%) chemotherapy was associated with a longer PFS than the lower one.
CONCLUSION
Higher reduction rates of M protein after the first and fourth chemotherapy cycles can act as advantageous prognostic factors for PFS in standard-risk group of MM patients during initial diagnosis.
PubMed: 37727707
DOI: 10.12998/wjcc.v11.i24.5643 -
International Journal of Surgery Case... Oct 2023Solitary spinal plasmacytoma (SSP) is an uncommon neoplasm originating from bone marrow plasma cells. Although infrequent in the thoracic region, it has the potential to...
INTRODUCTION AND IMPORTANCE
Solitary spinal plasmacytoma (SSP) is an uncommon neoplasm originating from bone marrow plasma cells. Although infrequent in the thoracic region, it has the potential to induce substantial damage. In this study, we present the case of a patient with thoracic spine SSP treated through surgical intervention.
CASE PRESENTATION
We report the case of a 38-year-old female who presented with progressive mid-back pain, numbness, weakness in both lower limbs and gait disturbance. Imaging showed an osteolytic lesion with vertebral collapse of T11. MRI was strongly suggestive of solitary plasmocytoma. Hematologic tests were normal. Surgery was carried out. At the first stage, a posterior approach with laminectomy and fixation were performed. Biopsy of tumor cells confirmed the diagnosis of SSP. At the second stage, a trans-thoracic approach was performed, the tumor was resected in a single block and anterior interbody fusion was done. After the surgery the patient fully recovered from the paraparesis and at two years follow up no recurrence of tumor cells was detected.
CLINICAL DISCUSSION
Spinal malignant bone tumors are rare, with solitary plasmacytoma being the most common. Diagnosis of SSP is based on bone biopsy findings. MRI and CT scans assess tumor extent and spinal stability. Prognosis relates to the likelihood of progressing into multiple myeloma. Though radiotherapy is common, surgery offers local control, especially for instability and neurological issues.
CONCLUSION
SSP in the thoracic spine is a rare condition that requires a multidisciplinary approach and a prompt treatment.
PubMed: 37738828
DOI: 10.1016/j.ijscr.2023.108799 -
Radiology Case Reports Nov 2023Plasmacytoma of the skull base is a rare entity. We present a case of sphenoid plasmacytoma in a 51-year-old woman who had nasal obstruction, intermittent epistaxis,...
Plasmacytoma of the skull base is a rare entity. We present a case of sphenoid plasmacytoma in a 51-year-old woman who had nasal obstruction, intermittent epistaxis, headaches, decreasing visual acuity, and diplopia. Computed Tomography (CT) scan and magnetic resonance imaging (MRI) showed a large heterogeneous, expansile lesion measuring 75 mm × 54 mm, centered on the sphenoidal bone and the clivus. Biopsy confirmed the diagnosis of solitary plasmacytoma after ruling out systemic spread by the initial assessment. The patient was successfully managed by external beam radiotherapy and a complete response was obtained after 12 months of follow-up.
PubMed: 37670923
DOI: 10.1016/j.radcr.2023.08.027 -
Radiology Case Reports Jan 2024Solitary plasmacytoma is a rare malignant tumor, presenting less than 5% of all plasma cell proliferation. Bone forms are the most frequent, affecting particularly the...
Solitary plasmacytoma is a rare malignant tumor, presenting less than 5% of all plasma cell proliferation. Bone forms are the most frequent, affecting particularly the axial bone skeleton, mandibular localization is extremely rare. Diagnosis is based on the presence of a localized plasma cell tumor without signs of a disseminated form. We report a case of 65 years old female patient with solitary bone plasmacytoma of mandible, who has undergone surgical treatment without adjuvant therapy, with a good clinical and radiological outcomes at 12 months follow-up.
PubMed: 37920692
DOI: 10.1016/j.radcr.2023.09.061 -
A Case Report of Plasmacytoma in a 28-Year-Old Patient: Bridging the Age Gap in a Rare Presentation.Cureus Oct 2023Plasmacytoma, an uncommon malignancy originating from plasma cells, predominantly manifests in the elderly demographic. However, its incidence among young adults remains...
Plasmacytoma, an uncommon malignancy originating from plasma cells, predominantly manifests in the elderly demographic. However, its incidence among young adults remains infrequent. Herein, we present a case involving a 28-year-old young adult diagnosed with solitary bone plasmacytoma. The patient presented with acute exacerbation of chronic lower back pain of two years, which, upon hospitalization, was attributed to a lumbar spine compression fracture. Comprehensive blood analysis, imaging studies, and pathology assessments suggested the likelihood of solitary plasmacytoma, devoid of indicators characteristic of multiple myeloma (MM). The patient was given symptomatic treatment and underwent surgical spine decompression, followed by the commencement of radiation therapy to address the malignancy. Subsequent to radiotherapeutic intervention, a noteworthy amelioration in pain and overall condition was observed. This case report assumes importance due to the insight it provides into the natural progression of solitary plasmacytoma. Patients with pathological fractures warrant thorough assessment for solitary plasmacytoma, necessitating vigilant monitoring for its potential evolution into MM. This case serves as a pertinent illustration of the need to expand our existing knowledge of solitary bone plasmacytoma, moving beyond the conventional notion that it predominantly afflicts the elderly population.
PubMed: 38022027
DOI: 10.7759/cureus.47671