Extramedullary plasmacytoma of the adenoids

Expect the Unexpected: Report of a Case of Pediatric Pharyngeal Extraosseous Plasmacytoma with Tumefactive Amyloidosis ("Amyloidoma") and a Review of the Literature

We report a rare case of localized pharyngeal tumefactive amyloidosis caused by extraosseous plasmacytoma in a 12 year-old girl who presented with otalgia, sore throat and blood stained sputum. The tumor was predominantly composed of amyloid with a limited component of well-differentiated neoplastic plasma cells, which were monoclonal (kappa restricted) on light chain in-situ hybridization. The amyloid deposits were positive for kappa immunoglobulin light chain on immunohistochemistry. The patient was treated with a combination of surgery and radiotherapy. Follow-up at 1 year showed no evidence of recurrence or progression.

Extramedullary plasmacytoma of the nasopharynx: A case report and review of the literature

Plasmacytoma is an extremely rare and discrete solitary mass of neoplastic monoclonal plasma cells. Extramedullary plasmacytoma (EMP) tends to occur during the fifth and seventh decades of life and is rarely diagnosed in younger patients. Only four cases of EMP have been previously reported in relatively young patients. Here we report a 15-year-old patient presenting with long-term nasal obstruction, who was found to have EMP of the nasopharynx. The patient was treated with surgery followed by radiotherapy with a satisfactory outcome. To the best of our knowledge, this study describes the the youngest individual with nasopharyngeal EMP to be reported in the literature.

Histologic analysis of pediatric tonsil and adenoid specimens: is it really necessary?

OBJECTIVE

To evaluate the incidence of unexpected histologic findings in routine tonsillectomy and adenoidectomy specimens.

METHODS

A retrospective medical record review was performed at a tertiary care children's hospital. The pathology records of 2062 children who underwent tonsil or adenoid surgery were analyzed and the final histologic diagnosis was recorded.

RESULTS

Four unexpected histologic findings were found on routine tonsil and adenoid specimens. None were clinically significant. A review of the literature shows a very low rate (0.015%) of unexpected clinically significant diagnoses in pediatric adenotonsillectomy specimens.

CONCLUSIONS

Given rarity of unexpected clinically significant diagnoses in pediatric adenotonsillectomy specimens, the cost and effort of analyzing each specimen histologically is difficult to justify.