Treatment of solitary extramedullary plasmacytoma of the stomach with endoscopic submucosal dissection

Extramedullary plasmacytoma (EMP) is an uncommon manifestation of plasma cell neplasia, which occurs outside the bone marrow. Intestinal involvement usually occur secondarily in multiple myeloma but it occur primarily less commonly. We experienced a woman who had a primary EMP localized in the stomach and the EMP was removed successfully by endoscopic submucosal dissection. The lesion was pathologically confirmed as confined to the gastric mucosa.

Plasmacytoma with amyloidosis masquerding as tuberculosis on cytology

Amyloid material on lymph node cytology smears can mimic caseous necrosis. We report one such case where a 50-year-old lady presented with a nasal mass and cervical lymphadenopathy. Fine needle aspiration cytology smears of the cervical lymph node were interpreted as tuberculous lymphadenitis based on the presence of an occasional epithelioid cell and caseous material. The patient did not respond to antituberculous therapy and was revaluated. Repeat aspiration from the lymph node showed numerous plasma cells and myeloma cells in addition to the amorphous material which was confirmed to be amyloid on staining with congo red. A diagnosis of plasmacytoma with amyloidosis was rendered. Imprint smears from nasal mass, detailed hematology workup and subsequent histology confirmed the diagnosis.

Endoscopic endonasal transsphenoidal resection of solitary extramedullary plasmacytoma in the sphenoid sinus with destruction of skull base

Solitary extramedullary plasmacytomas are isolated plasma cell tumors of soft tissue that typically do not metastasize. They are rare and account for 4% of all plasma cell tumors. To our knowledge, only 14 cases of solitary extramedullary plasmacytomas in the sphenoid sinus have been reported. A 32-year-old man presented to our department with complaint of ocular pain in the right eyeball and diplopia. Physical and neurological examinations revealed intact and prompt direct and indirect light reflexes in both pupils and limitation of extraocular muscle movement seen with the lateral gaze of the right eyeball. Magnetic resonance imaging suggested the presence of mucocele or mycetoma, therefore surgical resection was performed with endoscopic endonasal transsphenoidal approach. Histopathology was consistent with plasmacytoma. Systemic work-up did not show any evidence of metastasis and the sphenoid sinus was the sole tumor site, and therefore the diagnosis of solitary extramedullary plasmacytoma was confirmed. We report a rare case of solitary extramedullary plasmacytoma in the sphenoid sinus with successful treatment using the endoscopic endonasal transsphenoidal resection and adjuvant radiotherapy.

Alternating extra medullary plasmacytoma of maxilla

Plasmatytomas of maxilla are rare lesions. Alternating plasmacytoma of maxilla is still rare. A case of maxillary extra medullary plasmacytoma is reported in a patient, who presented with same lesion in the opposite maxillary sinus within one year of initial presentation. On review of available literature we could not find bilateral medullary plasmacytoma involving both maxilla one after another.