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QJM : Monthly Journal of the... Sep 2020
Topics: Humans; Magnetic Resonance Imaging; Multiple Myeloma; Plasmacytoma; Tomography, X-Ray Computed
PubMed: 32031633
DOI: 10.1093/qjmed/hcaa022 -
Nephrologie & Therapeutique Dec 2023Solitary plasmacytoma is a rare, localized malignancy. Bone localizations are the most common. Extramedullary plasmacytomas are much rarer. They are most often in the...
INTRODUCTION
Solitary plasmacytoma is a rare, localized malignancy. Bone localizations are the most common. Extramedullary plasmacytomas are much rarer. They are most often in the upper respiratory tract and can be complicated by amyloidosis. Here is an original report of a mediastinal extramedullary plasmacytoma revealed by type AA renal amyloidosis.
CASE PRESENTATION
We present the case of a 52-year-old patient with mediastinal extramedullary plasmocytoma diagnosed by renal failure due to type AA renal amyloidosis. Treatment was based on surgery with chemotherapy based on prednisone and melphalan. The patient presented end-stage renal failure that required hemodialysis at discharge.
CONCLUSION
Extramedullary plasmacytoma is a rare tumour that may be associated with amyloidosis, usually type AL. To our knowledge, its association with AA amyloidosis has not been reported in the literature. Treatment is based on surgery combined with radiotherapy or chemotherapy.
Topics: Humans; Middle Aged; Plasmacytoma; Amyloidosis; Serum Amyloid A Protein; Melphalan; Renal Insufficiency
PubMed: 38073243
DOI: 10.1684/ndt.2023.54 -
Ear, Nose, & Throat Journal Jul 2022Extramedullary plasmacytoma (EMP) is a tumor characterized by plasma cell proliferation in organs or tissues outside the bone marrow. It originates from B lymphocytes... (Review)
Review
Extramedullary plasmacytoma (EMP) is a tumor characterized by plasma cell proliferation in organs or tissues outside the bone marrow. It originates from B lymphocytes and can occur in all extramedullary tissues and organs of the body. Primary EMPs of the nasal cavity are relatively rare and mostly presented as case reports. Nasal EMP usually manifests as nasal obstruction, epistaxis, and progressive dyspnea. A 64-year-old man was admitted to our hospital because of rhinorrhagia with nasal obstruction. Computed tomography (CT) revealed a mass in the right nasal passage, which we resected under nasal endoscopy. At the 2-year follow-up, positron emission tomography/CT showed osteolytic bone destruction in the third cervical vertebra and its accessories, accompanied by increased metabolism. We considered the possibility of progression to myeloma, but the patient refused another puncture biopsy. We reviewed the literature for the clinical characteristics and CT findings of 14 patients pathologically confirmed with EMPs of the nasal cavity. All patients had nonspecific clinical manifestations, such as nasal obstruction and epistaxis. Computed tomography mostly showed a uniform-density polypoid mass in the nasal cavity. Therefore, nasal EMP should be included in the differential diagnosis of nasal polyps and other nasal tumors.
Topics: Epistaxis; Humans; Male; Middle Aged; Nasal Cavity; Nasal Obstruction; Nose Neoplasms; Plasmacytoma
PubMed: 33044842
DOI: 10.1177/0145561320960005 -
International Journal of Hematology Nov 2020We retrospectively analyzed 51 patients with solitary plasmacytoma diagnosed from October 2002 to September 2018 from a cohort of 3575 patients with plasma cell...
We retrospectively analyzed 51 patients with solitary plasmacytoma diagnosed from October 2002 to September 2018 from a cohort of 3575 patients with plasma cell dyscrasias registered in the Kansai Myeloma Forum. Twenty-seven patients had solitary bone plasmacytoma (SBP) and 24 had extramedullary plasmacytoma (EMP), with prevalence of 0.8% and 0.7%, respectively. The most frequent M protein was IgG (40%) in SBP, whereas non-secretory proteins were most frequent (50%) in EMP. Five-year overall survival was 78.2% in SBP and 80.8% in EMP (P = 0.894). Among patients with SBP, 44% progressed to MM with a median time of 10.5 months (2.4-93.3 months), whereas 8% of EMP patients progressed to MM with a median time of 18.6 months (13.0-24.2 months). The most frequent treatment was radiotherapy (41%) or observation (41%) in SBP, and chemotherapy (54%) in EMP. No statistically significant difference was observed upon univariate analysis of prognostic factors including age, sex, performance status, and IgG M protein. Our results suggest that there are biological differences between SBP and EMP in real-world settings.
Topics: Adult; Aged; Aged, 80 and over; Bone Neoplasms; Disease Progression; Female; Humans; Immunoglobulin G; Japan; Male; Middle Aged; Multiple Myeloma; Myeloma Proteins; Plasmacytoma; Prognosis; Registries; Retrospective Studies; Survival Rate
PubMed: 32783165
DOI: 10.1007/s12185-020-02961-3 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Jul 2022This paper reported a case of extramedullary plasmacytoma of the larynx. The patient presented with persistent hoarseness and foreign body sensation in pharynx for 5...
This paper reported a case of extramedullary plasmacytoma of the larynx. The patient presented with persistent hoarseness and foreign body sensation in pharynx for 5 months. Left anterior laryngeal mass, left epiglottis fold distention was found during laryngoscopy. Cervical image examination showed that the left side wall of the glottis was thickened and showed a lump-like change, part of which protrusion into the laryngeal cavity, the laryngeal chamber became narrow, and the growth of thyroid cartilage was broken outwards and reached the level of the hyoid bone. After completing the examination, the laryngeal tumor resection and biopsy were performed under the suspension laryngoscope. Pathologic findings showed that diffuse proliferation of small cells was observed in laryngeal subepithelial fibrous tissue, with local appearance of private, atypia and mitosis. Combined with immunohistochemical results, it was consistent with plasma cell tumor.
Topics: Epiglottis; Humans; Laryngeal Neoplasms; Laryngoscopy; Larynx; Plasmacytoma
PubMed: 35822386
DOI: 10.13201/j.issn.2096-7993.2022.07.015 -
World Neurosurgery May 2022The decision to perform surgery in cases of spinal plasmacytoma (SP) is controversial. This study aimed to evaluate the reliability of the Spinal Instability Neoplastic...
OBJECTIVE
The decision to perform surgery in cases of spinal plasmacytoma (SP) is controversial. This study aimed to evaluate the reliability of the Spinal Instability Neoplastic Score (SINS) in evaluation of spinal instability in patients with SP.
METHODS
Clinical and radiological characteristics of 10 patients with SP were retrospectively evaluated. Age, sex, preoperative symptoms, duration of symptoms, pain score, American Spinal Injury Association score, and SINS were analyzed.
RESULTS
The 10 patients included 6 men and 4 women. Plasmacytoma was located in the sacrum in 1 patient, in the lumbar spine in 2 patients, in the thoracic spine in 6 patients, and in the cervical spine in 1 patient. Biopsy was performed in 2 patients, biopsy and vertebroplasty were performed in 2 patients, and biopsy and acute decompression and stabilization surgery were performed in 6 patients. SINS was <7 in 1 patient, 7-12 in 5 patients, and >12 in 4 patients. Two patients with a low SINS (<13) underwent only biopsy, and 2 patients underwent biopsy and vertebroplasty. Decompression and stabilization surgery was performed in 2 patients with SINS 7-12 and 4 patients with SINS >12.
CONCLUSIONS
Decision making regarding augmentation, decompression, and stabilization in patients with SP is controversial. SINS may play a role during the decision-making process. Augmentation can be performed in patients with painful SPs with osteolytic changes with or without fracture (SINS <13). Decompression and stabilization surgery is the first-choice treatment in patients with SINS >12.
Topics: Cervical Vertebrae; Female; Humans; Male; Plasmacytoma; Reproducibility of Results; Retrospective Studies; Spinal Diseases
PubMed: 35134578
DOI: 10.1016/j.wneu.2022.02.008 -
International Journal of Spine Surgery Aug 2020Solitary plasmacytoma of bone has a predilection for the axial skeleton, most commonly affecting the thoracic spine. We report the case of a patient who presented with...
BACKGROUND
Solitary plasmacytoma of bone has a predilection for the axial skeleton, most commonly affecting the thoracic spine. We report the case of a patient who presented with acute on chronic back pain and developed severe neurologic deficits within several hours of admission secondary to a pathologic fracture of L1.
METHODS
The patient underwent an urgent magnetic resonance imaging scan followed by T12 to L2 posterior decompression and T11 to L3 posterior instrumented stabilization. Subsequent histopathologic examination of specimens taken at the time of surgery found this to be secondary to a plasmacytoma affecting the lumbar spine.
RESULTS
At follow-up, recovery has been rapid and extensive, with the patient remaining under hematologic review because of the risk for developing multiple myeloma.
CONCLUSIONS
The unique features of this case relate to the location of the plasmacytoma and the neurologic signs; to our knowledge this is the first reported case in the literature of paraplegia secondary to a lumbar spine plasmacytoma.
PubMed: 32986578
DOI: 10.14444/7074 -
Blood Nov 2023Most patients with solitary bone plasmacytomas (SBP) progress to multiple myeloma (MM) after definitive radiation therapy as their primary treatment. Whether the...
Most patients with solitary bone plasmacytomas (SBP) progress to multiple myeloma (MM) after definitive radiation therapy as their primary treatment. Whether the presence of high-risk (HR) cytogenetic abnormalities by fluorescence in situ hybridization (FISH) in the clonal plasma cells, obtained either directly from the diagnostic SBP tissue or the corresponding bone marrow examination at the time of diagnosis, is associated with a shorter time to progression (TTP) to MM is unknown. This study evaluated all patients diagnosed with SBP at the Mayo Clinic from January 2012 to July 2022. The presence of del(17p), t(14;16), t(4;14), or +1q (gain or amplification) by FISH in clonal plasma cells was defined as HR. A total of 114 patients were included in this cohort, and baseline FISH was available for 55 patients (48%), of which 22 were classified as HR (40%). The median TTP to MM for patients with SBP and HR FISH was 8 months (95% confidence interval [CI], 6.3-26) compared with 42 months (95% CI, 25-not reached [NR]) in patients with SBP without HR FISH (P < .001). In a multivariate analysis, only HR FISH was a significant predictor for shorter TTP to MM, independent of minimal marrow involvement and an abnormal serum free light chain ratio at diagnosis. Deletion (17p) and gain 1q abnormalities were the most common FISH abnormalities responsible for the short TTP to MM. Thus, assessing for HR FISH abnormalities in clonal plasma cells derived from either the diagnostic SBP tissue or the staging bone marrow examination of patients with newly diagnosed SBP is feasible and prognostic for a shorter TTP to MM.
Topics: Humans; Plasmacytoma; In Situ Hybridization, Fluorescence; Chromosome Aberrations; Multiple Myeloma; Prognosis; Disease Progression
PubMed: 37494698
DOI: 10.1182/blood.2023021187 -
Journal of the Korean Association of... Dec 2021Solitary plasmacytoma (SP) is an uncommon form of plasma cell neoplasm occurring intraosseously or in soft tissue and presents as a single mass of monoclonal plasma...
Solitary plasmacytoma (SP) is an uncommon form of plasma cell neoplasm occurring intraosseously or in soft tissue and presents as a single mass of monoclonal plasma cells. SP in the maxillary sinus is rare and can be misdiagnosed as other maxillary sinus tumors. The essential examinations in patients with the initial diagnosis of plasmacytoma are bone marrow biopsy, serum and urine electrophoresis, and kappa/lambda ratio (κ:λ ratio) to rule out multiple myeloma (MM). Herein, a rare case of SP in the maxillary sinus treated by surgery and localized radiation is reported. At the 10-year follow-up examination, local recurrence or disseminated development of MM were not evident.
PubMed: 34969021
DOI: 10.5125/jkaoms.2021.47.6.471 -
Turkish Journal of Haematology :... Feb 2022
Topics: Humans; Liver; Multiple Myeloma; Plasmacytoma
PubMed: 34753278
DOI: 10.4274/tjh.galenos.2021.2021.0545