Cases reported "Plasmacytoma"

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11/200. Hepatic plasmacytomas: case report and review of imaging features.

    Extramedullary plasmacytomas are uncommon and have a better prognosis than disseminated myeloma. We describe the second case of hepatic plasmacytomas (multiple) following a solitary bone plasmacytoma. The imaging characteristics of the few reported cases of these rare hepatic tumours are compared. The value of ultrasound in the assessment of liver lesions is emphasized.
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12/200. plasmacytoma of the mastoid bone: solitary and systemic.

    Plasma cell tumours of the mastoid are rare malignancies of haematological origin. Two patients are described with a plasma cell tumour in the mastoid bone. In one patient it concerned a solitary plasmacytoma of the bone and in the other a focus in the mastoid of a recently diagnosed multiple myeloma. Symptoms in these patients were non-specific. Computed tomography (CT) and magnetic resonance image (MRI) scanning showed a non-specific space-occupying lesion in the mastoid. The diagnosis was made on immunohistological examination, that showed diffuse sheets of monoclonal plasma cells in a clear matrix. When a plasmacytoma lesion is found multiple myeloma should always be excluded. Treatment in case of solitary plasmacytoma of the mastoid bone consists of radiotherapy. In case of localization in the mastoid of multiple myeloma the treatment consists of palliative chemotherapy.
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13/200. Extramedullary plasmacytoma of the orbit.

    PURPOSE: To report a case of extramedullary plasmacytoma of the orbit. methods: A 71-year-old patient presented with diplopia eyelid fullness and limitation of ocular motility in the left eye. visual acuity was counting fingers, intraocular pressure 34 mmHg and fundus eye examination showed choroidal folds in the involved eye. RESULTS: CT scan showed a mass filling the superior and external left orbit without bone destruction. A biopsy was performed revealing that the tumour was composed of plasmacytoid cells positive with immunohistochemical stains for Kappa light chains and epithelial membrane antigen. Systemic work up was negative. The diagnosis of extramedullary orbital plasmacytoma was made. The patient was treated with external beam radiotherapy (40 Gy) and has remained disease free for four years (49 months). CONCLUSION: Extramedullary plasmacytomas of the orbit are extremely rare tumours. Accurate and early diagnosis is essential for the therapeutic approach. Extensive medical work up to rule out multiple myeloma or other malignant lymphoproliferative conditions involving the orbit is needed when the diagnosis of orbital extramedullary plasmacytoma is suspected because treatment and prognosis are very different.
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14/200. Early detection of bone marrow involvement in extramedullary plasmacytoma by whole-body F-18 FDG positron emission tomography.

    The utility of positron emission tomography (PET) with the glucose analog 2-deoxy-2-[F-18] fluoro-D-glucose (F-18 FDG) in plasmacytoma has not been well evaluated. The authors report a case of extramedullary plasmacytoma (EMP) in which whole-body F-18 FDG PET was useful in the early detection of bone marrow involvement. A 34-year-old woman had EMP without histologic or radiologic evidence of bone lesions. However, the early phase of bone marrow involvement was considered because of spotty accumulation shown by F-18 FDG PET. A follow-up F-18 FDG PET study after radiotherapy showed intense multifocal accumulation in the bone marrow, which was confirmed on bone marrow aspiration as abnormal proliferation of plasma cells. Whole-body F-18 FDG PET has the potential to detect the early phase of bone marrow involvement in patients with EMP.
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15/200. IgD multiple myeloma preceding the development of extensive extramedullary disease without medullary involvement.

    We present a unique case of IgD multiple myeloma (MM) preceding the development of extensive extramedullary disease without medullary involvement. A 63-year-old man was diagnosed with IgD-lambda MM when he developed anemia. After 3 months of chemotherapy, he was in complete remission as evidenced by the disappearance of bone marrow (BM) plasmacytosis, monoclonal IgD protein in his serum, and Bence Jones proteinuria. Six months after diagnosis, his disease took an unusual course with the development of plasmacytomas in the skin, without medullary involvement. He then received chemotherapy, resulting in the complete disappearance of the subcutaneous plasmacytomas. Two years after the initial diagnosis, his disease took an aggressive clinical course with retroperitoneal relapse, leading to the patient's death within 1 month. The two separate episodes of extramedullary disease were associated with elevated serum lactic dehydrogenase levels and the absence of plasma cells in the BM. This case provides evidence of two separate transformations of the original malignant MM clone.
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16/200. Upper airways locations of plasmocytoma.

    We report one case of extramedullary plasmocytoma located in the nasopharynx. After 8 years, the tumor recurred in the same location and 3 years later, the patient develop a multiple myeloma. Three clinical and pathological entities of plasmocytoma are described: multiple myeloma, solitary bone plasmocytoma and extramedullary plasmocytoma. When histological examination show plasmocytoma, further examinations can or not reveal a multiple myeloma. In 80% of cases, extramedullary plasmocytoma occur in the upper respiratory tract. This development of multiple myeloma from extramedullary plasmocytoma is seen in 5 to 32% of patients and sometimes an extremely long time is required for the change to occur. The treatments are surgery and radiation in the absence of generalized disease.
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17/200. Nodal plasmacytoma with significant paraproteinaemia.

    We present a case of primary nodal plasmacytoma in an elderly Chinese woman that was associated with significant paraproteinaemia and paraproteinuria. Clinical and laboratory features of the patient satisfied Durie's criteria for the diagnosis of multiple myeloma. The present case was unusual in two aspects. Firstly, there was no evidence of clonal plasma cell proliferation elsewhere in the body after extensive radiological investigations, repeated bone marrow examinations, and polymerase chain reaction for immunoglobulin gene rearrangement study. Secondly, the clinical behaviour was indolent despite the large amount of paraprotein production, and showed satisfactory disease control with local radiotherapy. The differential diagnoses of plasmacytosis in the lymph node are also discussed.
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18/200. Primary plasmacytoma of the breast.

    We describe a solitary extramedullary plasmacytoma of the breast in a 37-year-old woman. No other involvement was detected in the bone marrow or in any other site during a 15-month follow-up period. Extramedullary plasmacytomas of the breast are extremely rare, especially those that are not associated with multiple myeloma. We review the histologic features of the previously reported cases with an emphasis on differential diagnosis and the difficulties encountered in arriving at the correct diagnosis in frozen sections.
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19/200. Diffuse primary plasmacytoma of the lung.

    Primary plasmacytoma of the lung is a rare tumor, thus presenting a diagnostic challenge to the clinician. So far, approximately 20 cases have been verified by immunohistochemistry. We describe an elderly patient presenting with progressive dyspnea on exertion, dry cough, weight loss and malaise. The main finding on plain chest radiography was a diffuse infiltration of pulmonary parenchyma in the lower parts of both lungs and in the middle part of the right lung. The histology of the open lung biopsy of the right middle lobe revealed massive and diffuse infiltration by well differentiated plasma cells with extracellular deposits of amyloid. The plasma cells and amyloid expressed a monoclonal lambda light chain. No monoclonal spike was shown by serum and urine immunoelectrophoresis. A skeletal survey and bone marrow biopsy specimen excluded a disseminated disease and a diagnosis of extramedullary plasmacytoma was made. The patient was considered for VI courses of VMCP chemotherapy after which a complete regression on chest roentgenography was evident. Almost five years after the diagnosis the patient is still alive without any evidence of disease recurrence or dissemination.
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20/200. Solitary osteosclerotic plasmacytoma: association with demyelinating polyneuropathy and amyloid deposition.

    A 51-year-old man presented with a 1-year history of polyneuropathy necessitating the use of a wheelchair. Initial diagnosis was idiopathic chronic inflammatory demyelinating polyneuropathy (CIDP) and associated monoclonal gammopathy. Investigations for multiple myeloma, including bone marrow aspiration and biopsy, were negative. What was initially felt to be an incidental osteosclerotic focus noted on the radiographic bone survey was eventually shown to be a solitary osteosclereotic plasmacytoma with associated amyloid. This dramatically altered treatment. This case emphasizes the importance of including osteosclerotic plasmacytoma in the differential diagnosis of a focal sclerotic bone lesion in the clinical setting of polyneuropathy. These lesions are less likely to progress to multiple myeloma than lytic plasma cell neoplasms, and the presence of polyneuropathy often results in earlier diagnosis and treatment with enhanced prospect of cure. The finding of amyloid deposition within the osteosclerotic lesion may be of prognostic importance.
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keywords = bone
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