Extramedullary Plasmacytoma Causing Myelopathy Resulting in Gait Imbalance.

Plasmacytomas are neoplasms of plasma cells that can involve the bone marrow, the bone itself, or soft tissue without bone marrow involvement. Extramedullary plasmacytomas are most commonly found in the upper respiratory tract in a total of 80% of all cases. Extramedullary plasmacytomas have also been documented in locations such as the central nervous system. This form of plasmacytoma may be seen as a solitary entity or in patients with multiple myeloma. We present a case of a 66-year-old female with a history of multiple myeloma on maintenance therapy with lenalidomide who has been experiencing gait imbalance for the past two months. The patient had a thoracic MRI done that revealed a mass at T7-8 with associated cord compression. She was taken for surgical intervention by neurosurgery. Pathology revealed trabecular bone and cartilage infiltrated by sheets of plasma cells highlighted by immunostaining CD138, monoclonal lambda light chains, consistent with a plasma cell neoplasm (plasmacytoma). The patient's hospital course was complicated by hypotension resulting in transient ischemic myelopathy that was addressed in the neuro-intensive care unit. The patient was then discharged to an inpatient rehabilitation center. She would follow up with her primary oncologist for localized radiation therapy.

Hyperplastic Gastric Polyp Causing Upper Gastrointestinal Hemorrhage and Acute Blood Loss Anemia.

Hyperplastic polyps are the second most common type of gastric polyp in the United States with equal incidence in both genders, usually found incidentally during endoscopic examinations. It is a well-known fact that they are associated with iron-deficiency anemia due to chronic blood loss. We present a case of a 69-year-old man with a relatively small hyperplastic gastric polyp with acute upper gastrointestinal bleeding, presenting with melena and acute blood loss anemia requiring admission to intensive care unit and urgent endoscopic intervention with hot snare removal of the polyp and cautery of surrounding area with excellent hemostasis. The pathology revealed focal intestinal metaplasia and low-grade dysplasia with no evidence of malignancy. He was subsequently discharged with outpatient follow-up with gastroenterology.