Primary gastric plasmacytoma: a rare entity

Diagnosis and management of extramedullary plasmacytoma in nasal cavity: Clinical experience and literature review

Nasal extramedullary plasmacytoma (EMP) is a rare plasma cell tumor that occurs in the soft tissue of the nasal cavity, and its imaging characteristics are still unclear. The purpose of this study was to investigate the clinical features, imaging findings, treatment, survival analysis, and prognosis of nasal EMP, and to provide a systematic review of the patients we treated and the published literature. A 45-year-old female patient who presented with epistaxis with nasal obstruction was recommended for magnetic resonance imaging to assess the nature of the lesion. On magnetic resonance imaging, abnormal signal shadow can be seen in the right nasal cavity. Diffusion weighted imaging showed signal of the lesion was significantly limited, presenting high signal, with a low apparent dispersion coefficient, and the lesion was significantly enhanced on contrast-enhanced scan. Combined with the clinical manifestations of the patient, who was initially considered to have a hemangioma. She underwent endoscopic nasal surgery under general anesthesia to remove the mass, and the final pathology confirmed it was EMP. However, the final pathology confirmed EMP. Five months later, the patient came to our hospital for follow-up and underwent fluorine-18-fluorodeoxyglucose/positron emission tomography/computed tomography scan, which showed no recurrence of the lesion and no transformation of multiple myeloma. The nasal EMP imaging findings were mostly soft tissue masses with uniform density or signal, which were significantly enhanced by enhancement scan, high signal on diffusion weighted imaging and low signal on apparent dispersion coefficient. Immunohistochemical staining for CD38, CD138, and CD79a was positive in most of the cases evaluated, while CD20 and CD10 were negative. The absence of dilated features, infiltrative features and the presence of significant contrast enhancement may be relatively specific imaging findings of nasal EMP. The prognosis of nasal EMP is good, and recurrence, metastasis, and transformation into multiple myeloma are rare. Because the lesions are sensitive to radiotherapy, surgical resection combined with radiotherapy is a more effective treatment.

Intestinal perforation with abdominal abscess caused by extramedullary plasmacytoma of small intestine: A case report and literature review

BACKGROUND

Extramedullary plasmacytoma (EMP) of the gastrointestinal tract is an extremely rare disease. Clinical manifestations of EMPs are varied and depend on the location and progression of the tumor.

CASE SUMMARY

Here, we firstly report a case of intestinal perforation with abdominal abscess caused by EMP of the small intestine in a 55-year-old female patient. The patient received emergency surgery immediately after the necessary preoperative procedures. During the operation, EMP was found to have caused the perforation of the small intestine and the formation of multiple abscesses in the abdominal cavity. Partial resection of the small intestine with peritoneal irrigation and drainage was performed. EMP was finally confirmed by postoperative histopathology and laboratory tests. Additionally, we performed a literature review of gastrointestinal EMP to obtain a deeper understanding of this disease.

CONCLUSION

EMP of the small intestine may have spontaneous perforation, which requires emergency surgery. Surgical resection can obtain good therapeutic effects.

A Rare Case of Extramedullary Plasmacytosis

Plasmacytosis is the abnormal proliferation of plasma cells in tissue, bone, blood, or exudates. Mucous membrane plasmacytosis is a rare form of plasmacytosis that is usually idiopathic in nature. A 68-year-old female underwent a diagnostic and therapeutic esophagogastroduodenoscopy, which revealed a friable antral erythematous gastric fold and a gastric polyp. Subsequent pathological testing was positive for diffuse polyclonal plasma cell proliferation, which was suggestive of a gastric plasmacytosis. In this article, we report a rare presentation of mucous membrane plasmacytosis.

Gastric plasmacytoma: a rare cause of upper gastrointestinal bleeding

A 43-year-old female presented to our department with hemoglobin of 3.4 g/dl. She denied gastrointestinal bleeding or weight loss. An upper endoscopy revealed an ulcerative lesion on the greater curvature of the gastric body with two visible clots. Two hemoclips were needed to attain hemostasis, as one of the biopsies of the tumor caused active spurting bleeding. An abdominal computed tomography (CT) demonstrated a well-circumscribed intramural mass arising in the gastric wall, measuring 65 x 50 x 90 mm, with marked internal vascularity and extraluminal component associated. The biopsies identified areas of mature and immature plasmocytes.