Imaging findings of primary gastric plasmacytoma: A case report

Solitary Giant Primary Gastric Plasmacytoma Mimicking Gastric Adenocarcinoma In Situ

A solitary extraosseous plasmacytoma is a rare type of plasma cell neoplasm. Its occurrence in the stomach is particularly unusual and can easily be mistaken for more common types of tumors. We describe a case involving a solitary extraosseous plasmacytoma in a patient who experienced weight loss as the sole symptom. Initially, the condition was misdiagnosed as gastric adenocarcinoma based on endoscopic biopsy results, leading to a gastrectomy after neoadjuvant chemotherapy. Subsequent examination of the pathological specimen revealed the presence of plasma cell neoplasia alongside a gastric adenocarcinoma in situ.

Extraosseous Plasmacytomas: A Radiologist's Perspective-A Narrative Review of the Literature

Extraosseous plasmacytomas (EPs) are rare neoplasms originating from plasma cells, often associated with multiple myeloma. EPs are classified into three subtypes: extramedullary myeloma, solitary extramedullary plasmacytoma (SEP), and multiple solitary plasmacytomas. They can manifest in various anatomical sites, including the lung, mediastinum, breast, liver, pancreas, stomach, mesentery, kidney, small and large bowel, testis, and soft tissue. Despite their rarity, EPs present a diagnostic challenge due to their non-specific imaging appearances, which can mimic other neoplastic and inflammatory conditions. This review aims to describe the radiographic features of EPs in the chest, abdomen, and pelvis based on a thorough analysis of the existing literature. While imaging plays a crucial role in the detection and characterization of EPs, histological confirmation is necessary to differentiate them from other neoplastic entities. The review underscores the importance of considering EPs in the differential diagnosis, particularly in patients with a history of multiple myeloma. Understanding the imaging characteristics of EPs is essential for accurate diagnosis and appropriate management. Early imaging is crucial in these patients to exclude the possibility of EP, as timely diagnosis can significantly impact patient outcomes.

18 F-FAPI-04 PET/CT in a Case of Primary Gastric Plasmacytoma

ABSTRACT

Primary plasmacytoma of the stomach is very rare. We describe contrast-enhanced CT and 18 F-FAPI-04 PET/CT findings in a patient with primary gastric plasmacytoma and Helicobacter pylori infection. The gastric tumor appeared as a large hypervascular polypoid mass on contrast-enhanced CT and showed intense 18 F-FAPI-04 uptake with SUV max of 11.8 on 18 F-FAPI-04 PET/CT.

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.

Extramedullary plasmacytoma involving rectum: A case report and literature review

Extramedullary plasmacytoma (EMP) of the gastrointestinal tract is an extreme rarity. Clinical manifestations of EMPs are varied, depending on the position and progress of tumor. Here we report a case of an EMP involving rectum in an 80-year-old, male patient with a change of bowel habit. Computed tomography scanning confirmed a circumscribed, iso-attenuating mass with the obvious heterogeneous enhancement. Patient received the surgical resection by laparoscope and the plasmacytoma was finally confirmed by the pathology. Furthermore, we made a literature review about the EMP of gastrointestinal tract to get the further study. Finally, we found out there is no specificity in imaging examination. Diagnosis of EMP still depends on the histopathology.

Gastrointestinal manifestations of extramedullary plasmacytoma: a narrative review and illustrative case reports

Introduction Solitary extramedullary plasmacytoma are rare, solid-mass tumours which appear immunophenotypically similar to multiple myeloma. The diagnosis and management of gastrointestinal plasmacytoma is complex and requires multidisciplinary input. This study presents a narrative review of intra-abdominal extramedullary plasmacytoma, illustrated with two case studies. Methods The PubMed database was searched without date restrictions for reports of intra-abdominal extramedullary plasmacytoma to synthesise a narrative review. Electronic records were reviewed at a high-volume, quaternary soft-tissue sarcoma centre to identify patients with histopathologically confirmed extramedullary plasmacytoma affecting the gastrointestinal tract. Results Gastrointestinal extramedullary plasmacytomas can present with mass effect or organ-specific dysfunction. Techniques for tissue diagnosis of extramedullary plasmacytoma vary dependent on location, with a formal diagnosis often being made from a resected specimen. Management can include surgery, radiotherapy, systemic chemotherapy or a combination. No high-quality evidence base exists to guide treatment. Two case studies of operated gastrointestinal extramedullary plasmacytoma are presented at different phases of disease progression, with a resultant impact on survival. Conclusion Intra-abdominal extramedullary plasmacytoma is a rare and heterogeneous condition that lacks consensus guidelines for diagnosis and management. Collaboration between international specialist centres will create better quality evidence for treatment of this cohort.

Primary gastric plasmacytoma: a rare entity

Extramedullary plasmacytomas (EP) are tumours composed by a monoclonal population of plasma cells that arise in extraosseus tissues, comprising <5% of all plasma cell neoplasms. Usually, EP arise in the head and neck region, and the stomach is the second most common location-gastric plasmacytoma (GP). Clinical and radiological manifestations are unspecific and may mimic other tumours like gastric adenocarcinomas, gastric stromal tumours and lymphomas, mainly marginal cell lymphoma (MALT lymphoma) and usually definitive diagnosis is provided by pathological evaluation. We present a case of primary GP, discovered incidentally as a polypoid lesion. Tumour was composed by sheets of mature and immature plasmocytes positive for CD138 on immunohistochemistry, without Helicobacter pylori identification. The patient is alive 6 years later and without tumour relapse.

Successful treatment of primary advanced gastric plasmacytoma using a combination of surgical resection and chemotherapy with bortezomib: A case report

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No general treatment guidelines have been established for gastricplasmacytoma.

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Combination therapy with chemotherapy involving bortezomib and autologous peripheral blood stem-cell transplantation after the resection could be one of the useful options for the advanced gastricplasmacytoma.

Introduction

Extramedullary plasmacytoma (EMP) is a plasma cell neoplasm that presents as a solitary tumor. EMP in the gastrointestinal organs are extremely uncommon.

Presentation of case

A 36-year-old man was admitted to our hospital with advanced anemia. He had no specific medical history. Gastroendoscopic findings showed an 8.0-cm submucosal tumor with ulcer on the greater curvature of the gastric body. Fine-needle aspiration was performed, and the pathologic diagnosis of the submucosal tumor was a plasmacytoma. Therefore, the patient was diagnosed with gastric plasmacytoma. A total gastrectomy was performed with lymphadenectomy. The result of intraoperative peritoneal lavage cytology was positive. Histological examination revealed serosa-exposed plasmacytoma of the stomach with lymph nodes metastasis. Additionaly the patient received a three-drug chemotherapy regimen (bortezomib, cyclophosphamide, and dexamethasone [VCD]) from 3 weeks after the operation. After 4 cycles of chemotherapy, the patient received autologous peripheral blood stem-cell transplantation (auto-PBSCT). Eighteen months after diagnosis, the patient is in complete remission with no evidence of local relapse or evolution to multiple myeloma.

Conclusions

This is the first reported case of advanced gastric plasmacytoma using adjuvant chemotherapy involving bortezomib and auto-PBSCT after the resection, and the patient has maintained a good course over a year. This protocol could be a new way to treat these tumors.