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Numata J, Tsunemine H, Imai A, Nakamura N, Sakai T, Itoh T, Arima N. Recurrence of solitary plasmacytoma in the liver 10 years after the onset of multiple bone lesions. J Clin Exp Hematop 2024; 64:65-70. [PMID: 38538320 PMCID: PMC11079988 DOI: 10.3960/jslrt.23056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/10/2024] [Accepted: 01/22/2024] [Indexed: 05/12/2024] Open
Abstract
A 79-year-old man presented with a history of solitary plasmacytoma in the bone 10 years ago. Chemoradiotherapy was effective, and remission was maintained with intermittent treatment at relapse of the bone lesions. One year after the last treatment, a follow-up computed tomography (CT) scan revealed multiple liver masses, and a liver biopsy revealed plasmacytoma. There was no clonal plasma cell infiltration in the bone marrow, and the final diagnosis was solitary plasmacytomas of the liver. Although liver involvement is known in relapsed refractory multiple myeloma, solitary plasmacytoma in the relapsed stage confined to the liver is rare, and all previous reports have been from the initial presentation. To the best of our knowledge, this is the first recurrent case of solitary plasmacytoma of the liver.
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Lamb MM, Zeatoun A, Stack TJ, Kim S, Albastoni S, Singer B, Klatt-Cromwell C, Senior BA, Kimple AJ, Thorp BD. Plasmacytoma of the Head and Neck: Case Series and Review of the Literature. ORL J Otorhinolaryngol Relat Spec 2023; 85:231-237. [PMID: 37364541 DOI: 10.1159/000530946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/24/2023] [Indexed: 06/28/2023]
Abstract
Solitary plasmacytoma is a rare neoplasm characterized by localized proliferation of monoclonal plasma cells and is classified as solitary bone or solitary extramedullary plasmacytoma. Here, we present two rare cases of plasmacytoma of the head and neck. The first is a 78-year-old male who presented with a 3-month history of epistaxis and progressive obstruction of the right nasal passage. Computerized tomography (CT) imaging revealed a mass in the right nasal cavity with destruction to the maxillary sinus. An excisional biopsy was performed revealing anaplastic plasmacytoma. The second is a 64-year-old male with a past medical history significant for prostate cancer who presented with a 2-month history of left ear pain and progressive non-tender temporal swelling. A PET/CT revealed a highly avid, destructive, and lytic left temporal mass with no other evidence of distant disease. A left temporal craniectomy and infratemporal fossa dissection revealed plasma cell dyscrasia with monoclonal lambda in situ hybridization. Although plasmacytomas are uncommon tumors of the head and neck, they may mimic other entities that require different treatment. Prompt and accurate diagnosis is critical for appropriate therapeutic decisions and prognosis.
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Affiliation(s)
- Meredith M Lamb
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA,
| | - Abdullah Zeatoun
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Taylor J Stack
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sulgi Kim
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sara Albastoni
- Department of Pathology & Laboratory Medicine at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Bart Singer
- Department of Pathology & Laboratory Medicine at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Cristine Klatt-Cromwell
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brent A Senior
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Adam J Kimple
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brian D Thorp
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
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Wu Y, Wei J, Chen S, Liu X, Cao J. A new prediction model for overall survival of elderly patients with solitary bone plasmacytoma: A population-based study. Front Public Health 2022; 10:954816. [PMID: 36176534 PMCID: PMC9513445 DOI: 10.3389/fpubh.2022.954816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/22/2022] [Indexed: 01/24/2023] Open
Abstract
Background Comprehensive studies on the prognosis of solitary bone plasmacytoma (SPB) are lacking, especially in elderly patients with SPB. This study aims to establish a novel nomogram and risk stratification system to predict the overall survival (OS) of elderly patients with SPB. Methods The data of elderly patients with SPB from 2000 to 2017 were identified in the SEER database. SPB patients were randomly assigned to the training set (n = 825) and validation set (n = 354). The Cox regression analysis was used to determine the independent risk factors for OS in elderly SPB patients. The nomogram was established and assessed by the area under the receiver operating curve (AUC), the consistency index (C-index), and the calibration plot. Patients were divided into low-, medium-, and high-risk groups based on the score of the nomogram. The Kaplan-Meier (K-M) curve was used to verify the differences in overall survival among the three groups. Result A total of 1,179 elderly patients with SPB were included in the study. Age at diagnosis, prior cancer before SPB, marital status, radiotherapy, and chemotherapy were independent risk factors of OS. The AUC of the 3, 5, and 8-year OS in the training and validation sets were between 0.707 and 0.860. The C-index and calibration plot also indicated that the nomogram has great predictive accuracy and robustness. After risk stratification, patients in the high-risk group had the worst OS. Conclusion A novel nomogram was built to predict the OS of elderly patients with SPB. It will help clinicians formulate more reasonable and personalized treatment strategies.
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Affiliation(s)
- Yingying Wu
- Department of Blood Transfusion, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jiemin Wei
- Department of Hematology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Shaomei Chen
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaozhu Liu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China,*Correspondence: Xiaozhu Liu
| | - Junyi Cao
- Department of Medical Quality Control, The First People's Hospital of Zigong City, Zigong, China,Junyi Cao
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Yao J, He X, Wang CY, Hao L, Tan LL, Shen CJ, Hou MX. Solitary plasmacytoma of the left rib misdiagnosed as angina pectoris: A case report. World J Clin Cases 2022; 10:7037-7044. [PMID: 36051148 PMCID: PMC9297416 DOI: 10.12998/wjcc.v10.i20.7037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/24/2021] [Accepted: 05/22/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Solitary plasmacytoma in the left rib is rare and can cause chest discomfort such as chest pain and tightness, and its clinical manifestations are not typical, so it is often misdiagnosed. We report a case of left costal plasmacytoma misdiagnosed as angina pectoris. We also review the literature and provide suggestions as to how to avoid misdiagnosis.
CASE SUMMARY A 77-year-old man with a history of intermittent chest tightness for 3 years presented with pain in the left chest for 1 wk and was admitted to hospital. The cardiologists initially diagnosed angina pectoris but the findings of coronary angiography were not consistent with the symptoms. Computed tomography showed that the left eighth rib mass was accompanied by bone destruction. The patient was transferred to our department for further treatment. Preoperative biopsy indicated that the lesion was possibly malignant, and elective surgery was performed to remove the lesion. The size of the tumor was about 4 cm. The tumor was spindle-shaped and protruded into the pleural cavity, without invading the lungs. Postoperative pathology confirmed that the left rib lesion was plasmacytoma. After 14 mo follow-up, the patient died of systemic metastasis.
CONCLUSION Left rib solitary plasmacytoma is a rare disease confined to a specific rib and can cause local pain. Attention should be paid to the differential diagnosis of angina pectoris to avoid misdiagnosis.
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Affiliation(s)
- Jian Yao
- Department of Cardiothoracic Surgery, Second Affiliated Hospital of Shenyang Medical College, The Veterans General Hospital of Liaoning Province, Shenyang 110001, Liaoning Province, China
| | - Xu He
- Department of Cardiothoracic Surgery, Second Affiliated Hospital of Shenyang Medical College, The Veterans General Hospital of Liaoning Province, Shenyang 110001, Liaoning Province, China
| | - Cheng-Yuan Wang
- Department of Cardiothoracic Surgery, Second Affiliated Hospital of Shenyang Medical College, The Veterans General Hospital of Liaoning Province, Shenyang 110001, Liaoning Province, China
| | - Li Hao
- Department of Pathology, Second Affiliated Hospital of Shenyang Medical College, the Veterans General Hospital of Liaoning Province, Shenyang 110001, Liaoning Province, China
| | - Li-Li Tan
- Department of Cardiology, Second Affiliated Hospital of Shenyang Medical College, the Veterans General Hospital of Liaoning Province, Shenyang 110001, Liaoning Province, China
| | - Chun-Jian Shen
- Department of Cardiothoracic Surgery, Second Affiliated Hospital of Shenyang Medical College, The Veterans General Hospital of Liaoning Province, Shenyang 110001, Liaoning Province, China
| | - Ming-Xiao Hou
- Department of Cardiothoracic Surgery, Second Affiliated Hospital of Shenyang Medical College, The Veterans General Hospital of Liaoning Province, Shenyang 110001, Liaoning Province, China
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Moore TM, Thomovsky SA, Thompson CA, Heng HG, Bentley RT. Case Report: Suspected Solitary Osseous Plasmacytoma in a Cat: Use of Magnetic Resonance Imaging to Diagnose and Confirm Resolution of Disease Following Chemotherapy. Front Vet Sci 2021; 8:752279. [PMID: 34676257 PMCID: PMC8523671 DOI: 10.3389/fvets.2021.752279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/27/2021] [Indexed: 11/13/2022] Open
Abstract
A 9-year-old female spayed Domestic Shorthair cat presented for pain, reluctance to jump, and hyporexia of 14 days duration. Neurologic examination was consistent with C6-T2 myelopathy. Magnetic resonance imaging (MRI) revealed a solitary, contrast-enhancing lesion within the T2 vertebral body. Solitary osseous plasmacytoma was diagnosed based on neurologic examination, advanced imaging, and clinicopathologic findings. Melphalan and prednisolone therapy were initiated. Complete resolution of clinical signs and the vertebral lesion were documented at a 2-year follow up examination with neurologic examination and repeat spinal MRI, respectively. Solitary osseous plasmacytoma are rare neoplasms in humans and domestic animals. As such, there is a paucity of published information regarding diagnostic criteria, MRI findings, treatment modalities, progression, and remission of disease in the feline patient. Most data are extrapolated from human medicine. The purpose of this report is to document neurologic exam and MR findings at the time of diagnosis and complete resolution of a solitary osseous vertebral plasmacytoma following melphalan and prednisolone therapy.
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Affiliation(s)
- Talisha M Moore
- Department of Veterinary Clinical Science, Purdue University, West Lafayette, IN, United States
| | - Stephanie A Thomovsky
- Department of Veterinary Clinical Science, Purdue University, West Lafayette, IN, United States
| | - Craig A Thompson
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, United States
| | - Hock Gan Heng
- Department of Veterinary Clinical Science, Purdue University, West Lafayette, IN, United States
| | - R Timothy Bentley
- Department of Veterinary Clinical Science, Purdue University, West Lafayette, IN, United States
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Stojanović N, Kostić A, Mitić R, Radisavljević M, Berilažić L. TOTAL SURGICAL RESECTION OF SOLITARY BONE PLASMACYTOMA OF THE SPINAL COLUMN. ACTA MEDICA MEDIANAE 2019. [DOI: 10.5633/amm.2019.0321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Mansilla C, Soria E, Vallejo M, Valiente A, Perez-Juana A, Zabalza A, Hurtado G, Sala F, Ramírez N. Combined Selection System to Lower the Cutoff for Plasma Cell Enrichment Applied to iFISH Analysis in Multiple Myeloma. Transl Oncol 2018; 11:647-652. [PMID: 29604510 PMCID: PMC6054590 DOI: 10.1016/j.tranon.2018.02.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/12/2018] [Accepted: 02/12/2018] [Indexed: 12/17/2022] Open
Abstract
Multiple myeloma (MM) is a very heterogeneous disease, characterized by multiple cytogenetic aberrations on plasma cells (PC) that have been traditionally used to predict the outcome of the disease. A mayor issue on the analysis of PC is the sometimes low infiltration of these cells in the bone marrow that hampers cytogenetic studies. To solve this problem we have optimized a selection strategy based on PC immunomagnetic isolation that has allowed us to lower to 1% the minimal PC infiltration requirement without loss of purity, enabling to perform genetic analysis. In this study, we have analyzed 153 bone marrow samples of patients suspected of MM, collected from February 2015 to May 2017 by the Genetics service of the Complejo Hospitalario de Navarra. Clinical characteristics of the patients and PC immunophenotyping, conventional cytogenetics and interphase fluorescence in situ hybridization (iFISH) analyses have been assessed on these samples. In our cohort 90% of the samples had cytogenetic abnormalities, among them 50% presented immunoglobulin rearrangements, 41.9% showed 1q gains, 29.7% showed 1p deletions and 33% presented TP53 deletion.
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Affiliation(s)
- Cristina Mansilla
- Oncohematology Research Group, Navarrabiomed, Complejo Hospitalario de Navarra, Universidad Pública de Navarra, IdiSNA
| | - Elena Soria
- Oncohematology Research Group, Navarrabiomed, Complejo Hospitalario de Navarra, Universidad Pública de Navarra, IdiSNA
| | - Miren Vallejo
- Oncohematology Research Group, Navarrabiomed, Complejo Hospitalario de Navarra, Universidad Pública de Navarra, IdiSNA
| | - Alberto Valiente
- Genetics Service, Complejo Hospitalario de Navarra, IdiSNA (Navarra's Health Research Institute), Pamplona, Spain
| | - Aránzazu Perez-Juana
- Genetics Service, Complejo Hospitalario de Navarra, IdiSNA (Navarra's Health Research Institute), Pamplona, Spain
| | - Amaya Zabalza
- Oncohematology Research Group, Navarrabiomed, Complejo Hospitalario de Navarra, Universidad Pública de Navarra, IdiSNA; Hematology Department, Complejo Hospitalario de Navarra, IdiSNA, Pamplona, Spain
| | - Guillermina Hurtado
- Cytometry Service, Hematology Department, Complejo Hospitalario de Navarra, IdiSNA, Pamplona, Spain
| | - Francisco Sala
- Cytometry Service, Hematology Department, Complejo Hospitalario de Navarra, IdiSNA, Pamplona, Spain
| | - Natalia Ramírez
- Oncohematology Research Group, Navarrabiomed, Complejo Hospitalario de Navarra, Universidad Pública de Navarra, IdiSNA.
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Chua SC, O'Connor SR, Wong WL, Ganatra RH. Case report: Solitary plasmacytoma of bone with oncogenic osteomalacia: recurrence of tumour confirmed by PET/CT. A case report with a review of the radiological literature. Br J Radiol 2008; 81:e110-4. [PMID: 18344267 DOI: 10.1259/bjr/58168443] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We describe a case of oncogenic osteomalacia secondary to solitary plasmacytoma of the vertebral body of T3. The patient presented with symptoms of hypophosphataemia. Following the initial diagnosis, the lesion was surgically resected with good results, although several follow-up procedures, including bone grafting, were necessary to stabilize the thoracic spine. The lesion recurred almost 15 years after its initial resection, again presenting with hypophosphataemia and neurological symptoms suggestive of local tumour recurrence. A variety of radiological examinations were performed in an attempt to confirm and localize recurrent tumour, including bone scintigraphy, (111)indium octreotide scintigraphy, high-resolution CT and MRI of the thoracic spine, but these yielded only negative or equivocal results owing, in part, to the presence of extensive post-operative changes, and also to a difference in the MR signals of the recurrent and original tumours. Positron emission tomography (PET/CT) demonstrated a solitary focus of intense fluorodeoxyglucose uptake in the T3 vertebral body, enabling a definitive diagnosis of recurrent plasmacytoma. This case illustrates the diagnostic value of PET/CT in the setting of challenging post-operative changes in the surrounding tissue and in the appearance of the tumour itself. Relevant related imaging literature is also reviewed.
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Affiliation(s)
- S C Chua
- Department of Radiology and Nuclear Medicine, Queen's Campus, Nottingham University Hospital, Derby Road, Nottingham, UK.
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Angtuaco EJC, Fassas ABT, Walker R, Sethi R, Barlogie B. Multiple myeloma: clinical review and diagnostic imaging. Radiology 2004; 231:11-23. [PMID: 14990813 DOI: 10.1148/radiol.2311020452] [Citation(s) in RCA: 204] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Multiple myeloma (MM) is a malignant clonal neoplasm of plasma cells of B-lymphocyte origin that commonly results in overproduction of large amounts of monoclonal immunoglobulins. Important advances in the therapeutic management of this disease in the past decade have resulted in higher rates of durable complete remission, prolonged event-free survival, and improved overall survival. Clearer understanding of the effects of abnormal plasma cells on bone has led to therapeutic approaches that help prevent vertebral body fractures. Current imaging technologies and, in particular, survey marrow studies with magnetic resonance (MR) imaging have improved detection of the extent and location of disease in MM patients. In newly diagnosed cases, MR surveys of the axial skeleton accurately demonstrate the extent of disease-diffuse or focal involvement-and the presence of associated compression fractures and cord compression. After treatment, MR images show the effects of treatment and the presence of residual disease. Multiple sites of focal bone lesions detected on MR studies allow a more appropriate choice of biopsy site than the usual random iliac marrow biopsy. Use of MR to determine biopsy sites and computed tomographic guidance for biopsy performance have increased the safety and accuracy of sampling. These biopsies have resulted in increased identification of cytogenetic abnormalities, particularly the presence of chromosome 13 deletion, which is a grave prognostic indicator in MM.
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Affiliation(s)
- Edgardo J C Angtuaco
- Department of Radiology and the Myeloma Institute, University of Arkansas for Medical Sciences, 4301 W Markham, Slot 596, Little Rock, AR 72205, USA.
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