ABSTRACT
Background: Extramedullary plasmacytoma (EMP) is an extremely rare kind of soft tissue plasma cell neoplasm without bone marrow involvement or other systemic characteristics of multiple myeloma. Primary pulmonary plasmacytoma (PPP), with no specific clinical manifestations, is an exceedingly rare type of EMP. Because of its complexity, PPP is often difficult to diagnose. Computed tomography-guided percutaneous core needle biopsy (CT-guided PCNB) has been shown to have high sensitivity, specificity and accuracy for characterization of pulmonary lesion, particularly if malignancy is suspected. Here we presented a rare case of PPP diagnosed with CT-guided PCNB. Case presentation: A 78-year-old female smoker who visited our outpatient clinic for a mass in the left lower lobe of the lung. Pathological based on CT-guided PCNB yielded a PPP with no lymph node or other distant metastasis. Conclusions: Extramedullary plasmacytoma should be considered in the differential diagnosis of a pulmonary mass.
ABSTRACT
BACKGROUND: Extramedullary plasmacytoma is a rare plasma cell neoplasm within soft tissue and without bone marrow involvement or other systemic characteristics of multiple myeloma. Primary pulmonary plasmacytoma is a rare type of extramedullary plasmacytoma. CASE PRESENTATION: A 48-year-old male with a tumor in the right middle ear was referred to our hospital. A routine chest X-ray was arranged and showed enlargement of the left lung hilum. His bilateral breathing sounded clear. A chest CT scan revealed a well-circumscribed mass. Pathological biopsy yielded a diagnosis of isolated pulmonary plasmacytoma. CONCLUSIONS: This is the first presentation of primary pulmonary plasmacytoma with a solitary pulmonary nodule and no lymph node involvement.
Subject(s)
Lung Neoplasms/pathology , Plasmacytoma/pathology , Solitary Pulmonary Nodule/pathology , Antineoplastic Agents/therapeutic use , Biopsy, Needle , Bone Marrow Examination , Bronchoscopy , Disease-Free Survival , Ear Neoplasms/diagnostic imaging , Ear Neoplasms/pathology , Ear Neoplasms/surgery , Ear, Middle/diagnostic imaging , Ear, Middle/pathology , Ear, Middle/surgery , Follow-Up Studies , Humans , Image-Guided Biopsy , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/drug therapy , Male , Middle Aged , Plasmacytoma/diagnostic imaging , Plasmacytoma/drug therapy , Solitary Pulmonary Nodule/diagnostic imaging , Solitary Pulmonary Nodule/drug therapy , Tomography, X-Ray ComputedABSTRACT
Extramedullary plasmacytoma(EMP) comprises 5% of all plasma cell neoplasms and commonly occurs in the upper airway or digestive tract. However, it rarely develops in the lungs. We present a case of primary pulmonary plasmacyotma in a 45 year old man, who presented as an endobronchial mass with a pleural effusion, but without evidence of multiple myeloma. The treatment options for EMP include surgery, surgery and radiotherapy, surgery and chemotherapy or chemotherapy alone. Surgery and radiation therapy appeared to be equally effective forms of treatment. The local recurrence rate was reported to be 30%, with 48% progressing to multiple myeloma, and median survival was reported to be 63-101 months. Our patient was initially treated with melphalan and prednisolone. However the disease progressed, and radiotherapy was combined with chemotherapy. In addition, the chemotherapy regimen was also changed to thalidomide and dexamethasone. The patient did not respond to this treatment regimen and finally died.
