1/21. multiple myeloma involving the jaws and oral soft tissues.A case of multiple myeloma with involvement of the oral cavity in a 75-year-old white man is reported. The patient had a two-year history of multiple myeloma. He had four intraoral soft tissue masses that were diagnosed as plasma cell myeloma. Each of these lesions was over a radiographically evident osteolytic lesion of the jaw. The patient was treated by irradiation and chemotherapy.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
2/21. Epstein-Barr virus-associated high-grade anaplastic plasmacytoma in a renal transplant patient.Allograft transplant patients have an increased risk of developing polyclonal or monoclonal lymphoproliferative disorders, but high-grade anaplastic plasmacytomas are extremely rare in these patients. We present a renal transplant patient who developed multiple extramedullary high-grade anaplastic plasmacytomas in the oral cavity, the left maxillary antrum, the scalp, the thigh and the upper abdominal wall with no evidence of diffuse bone marrow infiltration. Epstein-Barr virus (EBV) mRNA transcripts were detected within the myeloma cells by in situ hybridization using EBER1-2 probes. Following discontinuation of immunosuppression applied, the patient was treated with a cyclophosphamide-prednisone regimen followed by local irradiation, and a complete remission was achieved within four weeks. We concluded that EBV-associated high-grade anaplastic plasmacytomas constitute one more type of post-transplant lymphoproliferative disorder, and that despite their characterization as highly malignant neoplasms, their clinical behavior is not always aggressive.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
3/21. Fine-needle aspiration cytology of a case of hiv-associated anaplastic myeloma.Plasma cell neoplasia occurs much less frequently than high-grade B-cell non-Hodgkins lymphoma in hiv-infected patients, but is nevertheless an AIDS-associated malignancy. In this report, we describe the fine-needle aspiration (FNA) findings of a mass in the left parotid region with plasmablastic features that occurred in a 41-yr-old hiv-infected homosexual man whom we diagnosed as having anaplastic myeloma. The patient had normochromic, normocytic anemia with a hematocrit of 21%, a white blood count of 2.2 x 10(9)/l with 76% neutrophils, and a CD4 count of 31%. He also had elevated levels of calcium (13.2 mg/dl), alkaline phosphatase (25,400 IU/l), blood urea nitrogen (2,600 mg/dl), and creatinine (2.5 mg/dl). serum protein electrophoresis showed polyclonal hypergammaglobulinemia without any monoclonal component. A bone survey revealed multiple punched-out lytic lesions. FNA smears showed large plasmacytoid cells with eccentrically placed nuclei, prominent nucleoli, and moderate amounts of basophilic cytoplasm. By immunocytochemical staining, tumor cells were negative for CD19, CD20, and leukocyte-common antigen (LCA), but strongly positive for CD38 and kappa light chain. Anaplastic myeloma and plasmablastic lymphoma were considered in the differential diagnosis. Although the cytomorphologic and immunophenotypic findings of our case overlapped with those of plasmablastic lymphoma, the pattern of bone involvement with punched-out lytic lesions and absence of localization of the tumor to the mucosa of the oral cavity led us to a diagnosis of anaplastic myeloma. The patient initially received antiretroviral therapy followed by thalidomide and pulse dexamethasome therapy, but his response was poor. His hiv load increased, and his malignancy rapidly progressed with the development of multiple vertebral lesions, extraosseous extension, and eventually cord compression. He died of the disease less than 2 mo after presentation.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
4/21. Cutaneous plasmablastic lymphoma in an hiv-positive male: an unrecognized cutaneous manifestation.Plasmablastic lymphoma (PBL) is a rare and relatively new entity originally described in hiv-infected individuals. This subset of Epstein-Barr-virus (EBV)-related non-Hodgkin lymphomas is now regarded as a distinct clinicopathological category of AIDS-associated lymphomas occurring preferentially in the oral cavity and showing a poor prognosis. We describe for the first time an EBV-associated PBL with an isolated cutaneous distribution on the lower extremities in an hiv-infected heterosexual male and point to the unique clinical, morphological and immunophenotypic characteristics of this lymphoma. The patient presented with fast growing solid and livid nodules on both legs. The large, blastic tumor cells showed the following immunophenotype: CD138 , CD45 , CD20-, CD10-, CD3-, CD30-, bcl-2-, bcl-6-, LMP-1- and EMA-. The proliferation fraction (Mib-1) was >90%. EBV association was demonstrated by in situ hybridization (EBV-encoded RNAs 1/2). Polymerase-chain-reaction-based dna analysis demonstrated a clonal IgH rearrangement in the absence of a bcl-2/IgH translocation. PBL in hiv patients may occur not only in the oral cavity, but can probably involve any other organs including the skin.- - - - - - - - - - ranking = 2keywords = oral cavity, cavity (Clic here for more details about this article) |
5/21. plasmacytoma of the hard palate.multiple myeloma is a systemic malignant disease and is associated with a poor prognosis. It is characterized by neoplastic proliferation of plasma cells involved in the production and secretion of monoclonal immunoglobulins (M proteins). It is generally a disseminated disease involving many bones. Systemic symptoms include bone pain, pathologic fracture, renal failure, hypercalcemia, weight loss, anemia, thrombocytopenia, and neutropenia. This condition may occur as a solitary lesion (solitary plasmacytoma), which in some patients eventually progresses to plasma cell myeloma. Extramedullary plasmacytoma is defined as neoplastic proliferation of plasma cells in the soft tissue. It usually occurs in the upper respiratory tract, such as the nasal cavity or posterior oropharynx. The authors present a rare plasmacytoma case with maxilla involvement.- - - - - - - - - - ranking = 0.042320181702278keywords = cavity (Clic here for more details about this article) |
6/21. Extramedullary presentation of multiple myeloma in the parotid gland as first evidence of the disease -- a review with case report.Myeloma is a neoplasm of plasma cells that causes painful, bone-destructive lesions. It may present as a solitary lesion (plasmacytoma), or involve multiple sites (multiple myeloma). Myeloma may occur in an extraosseous location as a solitary lesion, or less commonly, in combination with multiple myeloma. oral manifestations may be the first sign or symptom of the disease. Soft tissue plasmacytomas of the head and neck tend to involve the nasal cavity or nasopharynx, rather than the oral cavity. Its occurrence in the parotid gland is rare. We present an unusual case of multiple myeloma with extramedullary involvement involving the parotid gland as first evidence of the disease. multiple myeloma should be considered in the differential diagnosis of salivary gland swellings.- - - - - - - - - - ranking = 1.0423201817023keywords = oral cavity, cavity (Clic here for more details about this article) |
7/21. Low grade multiple myeloma that presented as a labial swelling -- a case report.Myeloma is a disease of the bone marrow in which there is malignant proliferation of plasma cells. Myeloma is usually associated with the accumulation of a monoclonal immunoglobulin or light chains in plasma and subsequently an increase in light chains in the urine (Bence-Jones proteins). Renal failure can occur and bone destruction in the axial skeleton may ensue with pain and fractures. amyloidosis associated with multiple myeloma is a relatively common finding. The most frequently reported oral sign of amyloidosis is macroglossia. There are numerous cases in the literature of amyloid deposition in tongues related to multiple myeloma. However, none of these cases describe amyloid deposition surrounding arteries in the oral cavity. We therefore report a case of an innocuous lower labial swelling, which subsequently led to the diagnosis of amyloid deposition surrounding an artery, the cause of which was later shown to be multiple myeloma.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
8/21. Plasmablastic lymphoma in hiv-positive patients: an aggressive Epstein-Barr virus-associated extramedullary plasmacytic neoplasm.AIDS-associated aggressive B-cell lymphomas often have plasmacytoid features. Plasma cell neoplasms in hiv patients were commonly described to have atypical morphology and an aggressive clinical course in the literature. We reviewed 14 cases of neoplasms with marked plasmacytic differentiation in hiv-positive patients to determine their clinicopathologic features. Of these, 13 of 14 had homogeneous morphology and were generally CD45( ), CD20-, PAX-5-, and CD138( ). All were positive for Epstein-Barr virus-encoded rna (EBER) but lacked EBV late membrane proteins (LMP). Human herpes virus 8 (HHV8) dna was detected in 6 of 10 cases by nested PCR, but HHV8 latent nuclear antigen (LNA) was absent. The 13 patients ranged in age from 28 to 44 years (median, 41 years) (11 male patients; 2 female patients). All patients had extramedullary and 11 of 13 had extranodal tumor at the initial presentation; 2 had distant marrow involvement. The most commonly involved location was the oral cavity (6 of 13 cases), followed by bone and soft tissue (4 of 13), and the gastrointestinal tract (3 of 13). All 11 patients with follow-up died within 34 months (median, 7 months). The 14th patient who had a nodal disease with more undifferentiated morphology and expression of the HHV8 LNA protein was alive without disease at last follow-up (>72 months), probably representing a novel HHV8( ) lymphoma. We conclude that most plasmacytic tumors in hiv-positive individuals are extramedullary, clinically aggressive EBV( ) tumors identical to plasmablastic lymphoma that does not have the clinical features of plasma cell myeloma.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
9/21. Visceral varicella zoster virus infection after stem cell transplantation: a possible cause of severe abdominal pain.Reactivation of varicella zoster virus (VZV) is a common event after stem cell transplantation (SCT). When activated in the abdominal cavity, the infection may be life threatening. Visceral presentation with VZV infection is uncommon, although probably an under-diagnosed event in post-SCT patients. The interval from onset of abdominal pain to the development of skin eruptions may delay the initiation of specific antiviral therapy and symptoms may be incorrectly diagnosed as surgical disease or graft-versus-host disease. We describe the case of a 53-year-old man who had undergone stem cell autograft for multiple myeloma and developed visceral VZV infection with hepatitis, melaena and subileus 7 months later.- - - - - - - - - - ranking = 0.042320181702278keywords = cavity (Clic here for more details about this article) |
10/21. Palifermin in a hematopoietic stem cell transplant patient with osteonecrosis of the jaw.This case report describes the use of palifermin in a multiple myeloma patient with a history of osteonecrosis of the jaw (ONJ) for the prevention of high-dose chemotherapy-induced mucositis. Following the day of autologous stem cell infusion, palifermin was discontinued secondary to adverse events. Specifically, palifermin-associated macroglossia seemed to exacerbate the pain localized in the oral cavity area affected by ONJ, necessitating escalated doses of narcotic analgesics. When contemplating palifermin as a mucosal protectant in a hematopoietic stem cell transplant patient with ONJ, a careful benefit-to-risk assessment is in order to ensure optimal effectiveness without undue harm.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
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