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Medicine Dec 2017Gastrointestinal solitary extramedullary plasmacytoma (EMP) is rare, just occupies about 5% of all EMPs. The most common site is small intestine followed by stomach. The... (Review)
Review
RATIONALE
Gastrointestinal solitary extramedullary plasmacytoma (EMP) is rare, just occupies about 5% of all EMPs. The most common site is small intestine followed by stomach. The colorectal incidence is much rare.
PATIENT CONCERNS
A 63-year-old female had an episodic pain around the umbilicus for about one week. The hyperemia and edema in the ileocecal mucosa were found in colonoscopy, and the endoscopy could not cross the ileocecal valve. The pathology specimens showed a high index suspicion of plasmacytoma.
DIAGNOSES
The patient was diagnosed with extramedullary plasmacytoma.
INTERVENTIONS
A right hemicolectomy surgery was performed to treat the disease.
OUTCOMES
Post surgery pathologic report showed low grade malignant mucosa associated marginal zone B cell lymphoma.
LESSONS
We report a case of an extramedullary plasmacytoma in ileocecum with abdominal pain and a review of extramedullary plasmacytoma.
Topics: Cecal Neoplasms; Colectomy; Female; Humans; Ileal Neoplasms; Middle Aged; Plasmacytoma
PubMed: 29390503
DOI: 10.1097/MD.0000000000009313 -
Journal of Cancer Research and... 2015Solitary plasmacytoma most commonly presents in bone (80%), while extramedullary plasmacytoma (EMP) is an uncommon (20%) entity that most commonly involves nasopharynx... (Review)
Review
Solitary plasmacytoma most commonly presents in bone (80%), while extramedullary plasmacytoma (EMP) is an uncommon (20%) entity that most commonly involves nasopharynx or upper respiratory tract. Involvement of the gastrointestinal tract occurs in approximated 10% of EMP cases, in that also solitary EMP of the rectum is an exceedingly rare entity. Here we are presenting a case of 55-year-old male patient who was diagnosed to have EMP of rectum in September 2012 who was initially operated in which de-bulking surgery with abdominoperineal resection was done with large residual lesion postoperatively. Then patient was treated with postoperative radiotherapy (RT) with conventional portals 40 Gy in 20 fractions with complete response at 3 months. Patient was followed-up until now (1 year and 2 months post-RT), without any symptom or recurrence.
Topics: Combined Modality Therapy; Humans; Male; Middle Aged; Plasmacytoma; Radiography; Rectal Neoplasms
PubMed: 26458684
DOI: 10.4103/0973-1482.140799 -
Medicine Mar 2023Plasmacytoma is a rare plasma cell dyscrasia that grows within the axial skeleton or soft tissue structures as solitary or multiple masses. The primary types are... (Review)
Review
RATIONALE
Plasmacytoma is a rare plasma cell dyscrasia that grows within the axial skeleton or soft tissue structures as solitary or multiple masses. The primary types are solitary plasmacytoma, including solitary bone plasmacytoma (SBP) and solitary extramedullary plasmacytoma, and multiple solitary plasmacytomas. SBP is characterized by localized proliferation of monoclonal plasma cells and is rare. However, SBP with chronic osteomyelitis is even rarer.
PATIENT CONCERNS
A 47-year-old man previously diagnosed with chronic osteomyelitis presented with repeated discharge and ulceration in the front of his right tibia.
DIAGNOSIS, INTERVENTIONS AND OUTCOMES
Lower extremity magnetic resonance imaging (MRI) and computed tomography (CT) examinations showed dead bone formation and surrounding inflammatory edema. Thus, the patient underwent dead bone excision and fenestration of the bone marrow cavity. The histopathologic examination results indicated plasmacytoma. Therefore, we administered radiotherapy with satisfactory results.
LESSONS
Physicians should pay close attention to chronic osteomyelitis because it may be accompanied by plasmacytoma. Postoperative pathological and immunohistochemical examinations are crucial, and surgical resection of the lesion and local radiotherapy are effective treatment methods.
Topics: Male; Humans; Middle Aged; Plasmacytoma; Tibia; Plasma Cells; Bone Neoplasms; Osteomyelitis
PubMed: 36961183
DOI: 10.1097/MD.0000000000033307 -
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 -
Korean Journal of Radiology 2015To describe the imaging features of pelvic solitary plasmacytoma and to correlate them with the pathologic grade.
OBJECTIVE
To describe the imaging features of pelvic solitary plasmacytoma and to correlate them with the pathologic grade.
MATERIALS AND METHODS
A retrospective study was performed on the imaging features of 10 patients with a histological diagnosis of pelvic solitary plasmacytoma. The imaging studies were assessed for bone expansion, cortical destruction, signal intensity/density of soft tissue mass and enhancement manifestations, which were then correlated to the pathologic grade.
RESULTS
The imaging features of pelvic solitary plasmacytoma revealed 3 different types: multilocular type (n = 5), unilocular type (n = 2) and complete osteolytic destruction type (n = 3) on computed tomography and MRI. Pathologically, the tumors were classified into low, intermediate and high grades. Features such as multilocular change, perilesional osteosclerosis, slight expansion, local bone cortex disruptions and masses inside bone destruction, often suggest a low-grade solitary plasmacytoma; complete osteolytic destruction, huge soft tissue mass, and osseous defects imply a higher pathologic grade.
CONCLUSION
Pelvic solitary plasmacytoma has various imaging manifestations, while a slight expansile osteolytic feature with multilocular change or homogeneous enhancement highly suggests its diagnosis. The distinctive imaging features of pelvic solitary plasmacytoma are well correlated to the pathologic grade.
Topics: Adult; Aged; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Neoplasm Grading; Pelvic Neoplasms; Plasmacytoma; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 25598683
DOI: 10.3348/kjr.2015.16.1.146 -
Bioengineered May 2022Long non-coding RNA (lncRNA) plasmacytoma variant translocation 1 (PVT1) and growth arrest specific 5 (GAS5) have opposite functions in the apoptosis of chondrocytes,...
Long non-coding RNA (lncRNA) plasmacytoma variant translocation 1 (PVT1) and growth arrest specific 5 (GAS5) have opposite functions in the apoptosis of chondrocytes, which are involved in the pathogenesis of osteoarthritis (OA). The opposite roles of PVT1 and GAS5 in OA may indicate the existence of crosstalk between them in OA. This study aimed to explore the possible interaction between PVT1 and GAS5 in OA. Accumulation of PVT1 and GAS5 in OA and control synovial fluid samples was measured by RT-qPCR. The interaction between PVT1 and GAS5 in chondrocytes was explored by overexpression experiments. Dual-luciferase reporter assay was performed to analyze the binding of PVT1 and GAS5 to each other's promoter regions. Regulatory roles of PVT1 and GAS5 in the apoptosis of chondrocytes were studied with cell apoptosis assay. PVT1 was upregulated in OA, and GAS5 was downregulated in OA. An inverse correlation between PVT1 and GAS5 was observed across OA samples. Under lipopolysaccharides (LPS) treatment, PVT1 was upregulated and GAS5 was downregulated. Interestingly, PVT1 and GAS5 overexpression downregulated each other in chondrocytes. Cell apoptosis analysis showed that PVT1 overexpression promoted cell apoptosis, while GAS5 overexpression suppressed cell apoptosis induced by LPS. Co-transfection of PVT1 and GAS5 failed to significantly affect cell apoptosis. PVT1 and GAS5 directly bound to each other's promoter regions. Our study characterized the interaction between PVT1 and GAS5 in OA. Their interaction regulated the apoptosis of chondrocytes, which play a critical role in OA. PVT1 and GAS5 may form a negative feedback loop in OA.
Topics: Apoptosis; Chondrocytes; Humans; Lipopolysaccharides; MicroRNAs; Osteoarthritis; Plasmacytoma; RNA, Long Noncoding
PubMed: 35706414
DOI: 10.1080/21655979.2022.2063653 -
British Journal of Cancer Jan 1995The clinical features and response to therapy of 32 Chinese patients with localised plasmacytoma are presented, and a comparison between extramedullary plasmacytoma... (Comparative Study)
Comparative Study
The clinical features and response to therapy of 32 Chinese patients with localised plasmacytoma are presented, and a comparison between extramedullary plasmacytoma (EMP) and solitary plasmacytoma of bone (SPB) is made. Twenty-two patients had SPB and ten had EMP, accounting for 9% of all of our plasma cell neoplasms. Both groups had a male predominance with a median age of 54 years for SPB and 63 years for EMP. The common sites of SPB included vertebral bodies (15) and the skull (4). Most EMPs occurred in the oronasopharynx (6) and paranasal sinuses (2). An M-protein was detected in eight patients with SPB and in six with EMP. Seventeen patients with SPB and seven with EMP received radiation therapy, and all achieved initial local control. The pattern of failure in 22 patients with SPB manifested as local recurrence in two, multiple bone metastases without bone marrow plasmacytosis in two, multiple EMP progression in two, and development of multiple myeloma (MM) in one. There were two local recurrences, one further solitary bone involvement and one MM conversion in the EMP group. Local recurrence or dissemination was associated with the appearance of M-protein or an increase in the M-protein level in both groups. There was no significant difference in M-protein status or incidence and patterns of failure between the two groups. Patients with EMP had a more favourable overall survival than those with SPB (P = 0.03). The 5 year disease-free survival rate was 79% for EMP and 58% for SPB (P = 0.53). Patients aged less than 60 years had a better overall survival in the SPB group, but location of tumour, presence of M-protein, radiation dose and chemotherapy did not influence prognosis in either group. Our results indicate that adequate local therapy can result in long-term survival with a low frequency of MM progression for patients with localised plasmacytomas, and both EMP and SPB appear to be similar in terms of frequency and patterns of failure.
Topics: Adult; Aged; Bone Neoplasms; Female; Humans; Male; Middle Aged; Plasmacytoma; Prognosis; Retrospective Studies; Survival Rate
PubMed: 7819027
DOI: 10.1038/bjc.1995.26 -
Diagnostic and Interventional Imaging Oct 2021To compare conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) in the differentiation of bone plasmacytoma from bone metastasis in the...
PURPOSE
To compare conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) in the differentiation of bone plasmacytoma from bone metastasis in the extremities.
MATERIALS AND METHODS
A total of 65 patients with 27 bone plasmacytomas (11 men; mean age, 63.6±8.2 [SD] years) and 38 patients with bone metastases (20 men; mean age, 64.1±11.5 [SD] years) were retrospectively included. Plasmacytomas and metastases were compared for size, peritumoral edema, signal intensity (SI), SI pattern, apparent diffusion coefficient (ADC) values and standard deviation (SD) of ADC. Receiver operating characteristic analysis with area under the curve (AUC) was used to calculate sensitivity, specificity, and accuracy of MRI and DWI for the diagnosis of plasmacytoma according to a defined cut-off value.
RESULTS
On conventional MRI, plasmacytomas showed less peritumoral edema (22% vs. 71%; P<0.001), were more often hyperintense on T1-weighted image (48% vs. 18%; P=0.022) and more homogeneous on T2-weighted image (78% vs. 26%; P<0.001) and contrast-enhanced T1-weighted images (70% vs. 25%; P=0.001) than bone metastases. Mean ADC value and SD of ADC were significantly lower in bone plasmacytomas (760.1±196.9 [SD] μm/s and 161.5±62.7 [SD], respectively) than in bone metastases (1214.2±382.6 [SD] μm/s and 277.0±110.3 [SD], respectively) (P<0.001). Using an ADC value≤908.3μm/s, DWI yielded 88% sensitivity and 78% specificity for the diagnosis of plasmacytoma. ADC value yielded best area under the curve (AUC=0.913), followed by SD of ADC (AUC=0.814) and homogeneity on T2-weighted images (AUC=0.757). The combination of conventional MRI and DWI (AUC=0.894) showed improved diagnostic performance over conventional MRI alone (AUC= 0.843) for discriminating between plasmacytoma and metastasis.
CONCLUSION
Conventional MRI in combination with DWI can be useful to discriminate between bone plasmacytoma and bone metastasis in the extremities.
Topics: Aged; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Extremities; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Plasmacytoma; Retrospective Studies; Sensitivity and Specificity
PubMed: 34127433
DOI: 10.1016/j.diii.2021.05.009 -
Journal of Medical Case Reports May 2019Primary plasmacytomas are localized proliferations of clonal plasma cells occurring in the absence of a systemic plasma cell dyscrasia such as multiple myeloma. Primary... (Review)
Review
BACKGROUND
Primary plasmacytomas are localized proliferations of clonal plasma cells occurring in the absence of a systemic plasma cell dyscrasia such as multiple myeloma. Primary plasmacytomas most commonly manifest as solitary lesions of the bone or of the upper aerodigestive tract. Presentation in a lymph node is very uncommon and can often be initially mistaken for lymphoma. Because they are local phenomena, primary plasmacytomas are managed with local therapies such as radiation or, less commonly, excision. Multifocal presentations are rare and are often not amenable to local treatment modalities, thus requiring systemic therapies. Because of their rarity, standardized treatment guidelines are not established, and treatment paradigms borrow heavily from those employed in multiple myeloma. Multifocal presentation in lymph nodes is nearly unheard of with only seven such cases reported in the existing literature, only four of which were diffuse enough to require systemic therapy. Here we describe the most diffuse and widely distributed instance of primary lymph node plasmacytoma yet reported and present a description of its successful treatment with systemic therapy.
CASE PRESENTATION
A 71-year-old Asian man presented with progressive fatigue in the setting of diffuse hypermetabolic lymphadenopathy throughout his chest, abdomen, and pelvis. A diagnosis of lymphoma was initially suspected; however, a lymph node biopsy was consistent with plasmacytoma. A bone marrow biopsy was unremarkable, and no monoclonal protein was identified, establishing a diagnosis of primary extramedullary plasmacytomas of the lymph nodes. He was treated with a myeloma-like regimen consisting of four cycles of bortezomib/dexamethasone followed by two cycles of thalidomide/prednisone with improvement in symptoms and near complete resolution of prior hypermetabolic lymphadenopathy. He remains in remission over 18 months following completion of therapy.
CONCLUSION
This case report and accompanying literature review highlight the exceedingly rare and easily misclassified entity of primary plasmacytoma of diffuse lymph nodes. Importantly, we demonstrate that this entity may be treated with, and demonstrate excellent response to, systemic therapies often employed in multiple myeloma.
Topics: Aged; Bortezomib; Dexamethasone; Fatigue; Humans; Lymph Nodes; Lymphadenopathy; Male; Plasma Cells; Plasmacytoma; Prednisone; Remission Induction; Thalidomide
PubMed: 31113466
DOI: 10.1186/s13256-019-2087-7 -
Turkish Journal of Haematology :... Feb 2022
Topics: Humans; Liver; Multiple Myeloma; Plasmacytoma
PubMed: 34753278
DOI: 10.4274/tjh.galenos.2021.2021.0545