We report a rare case of extramedullary plasmocytoma associated with a massive deposit of amyloid in the duodenum.A 72-year-old Japanese man was admitted to our hospital presenting with a 3-mo history of epigastric pa...We report a rare case of extramedullary plasmocytoma associated with a massive deposit of amyloid in the duodenum.A 72-year-old Japanese man was admitted to our hospital presenting with a 3-mo history of epigastric pain, vomiting and weight loss.On computed tomography(CT) a wall thickening of the fourth part of the duodenum was observed.Multiple biopsies obtained from the lesion showed inflltration of plasma cells and lymphocytes, but they were not conclusive.The patient underwent resection of the lesion and, on histopathological examination, the lesion consisted of a dense and diffuse inflltrate of plasma cells and a few admixed lymphocytes with reactive follicles extending to the muscular propria.An extensive deposition of amyloid was also observed.Immunohistochemical stains revealed that a few plasmacytoid cells showed λ light chain staining, though most were κ light chain positive.These cells also were positive for CD138 and CD56 but negative for CD20 and CD79.The flndings were consistent with extramedullary plasmocytomaassociated with a massive deposit of amyloid in duodenum.A subsequent workup for multiple myeloma was completely negative.The patient showed no signs of local recurrence or dissemination of the disease after 12 mo follow-up.Because of the association of plasmocytoma and amyloidosis, the patient must be followed up because of the possible systemic involvement of the neoplasm and amyloidosis in future.展开更多
Pancreatic carcinoma is a debilitating disease and carries a poor prognosis. It is a rare cause of upper gastrointestinal bleeding, even though pancreas, stomach, duodenum and jejunum are adjacent organs. The incidenc...Pancreatic carcinoma is a debilitating disease and carries a poor prognosis. It is a rare cause of upper gastrointestinal bleeding, even though pancreas, stomach, duodenum and jejunum are adjacent organs. The incidence of pancreatic adenocarcinoma directly invading the gastrointestinal tract leading to gastrointestinal hemorrhage is very low, and most of them present with melena and hematochezia. Here, we describe one unique case manifesting characteristically severe and unremitting hematemesis as an initial presentation of pancreatic adenocarcinoma. This tumor directly invaded the duodenal mucosa as a bleeding protruding tumor mass. Our MEDLINE search has confirmed that this is the first reported case with an initial manifestation of hematemesis from pancreatic adenocarcinoma in Asians.Pancreatic adenocarcinoma directly invading duodenum complicated by hemorrhage can be a rare cause of hematemesis, and clinicians should be reminded of it while they are making differential diagnosis.展开更多
文摘We report a rare case of extramedullary plasmocytoma associated with a massive deposit of amyloid in the duodenum.A 72-year-old Japanese man was admitted to our hospital presenting with a 3-mo history of epigastric pain, vomiting and weight loss.On computed tomography(CT) a wall thickening of the fourth part of the duodenum was observed.Multiple biopsies obtained from the lesion showed inflltration of plasma cells and lymphocytes, but they were not conclusive.The patient underwent resection of the lesion and, on histopathological examination, the lesion consisted of a dense and diffuse inflltrate of plasma cells and a few admixed lymphocytes with reactive follicles extending to the muscular propria.An extensive deposition of amyloid was also observed.Immunohistochemical stains revealed that a few plasmacytoid cells showed λ light chain staining, though most were κ light chain positive.These cells also were positive for CD138 and CD56 but negative for CD20 and CD79.The flndings were consistent with extramedullary plasmocytomaassociated with a massive deposit of amyloid in duodenum.A subsequent workup for multiple myeloma was completely negative.The patient showed no signs of local recurrence or dissemination of the disease after 12 mo follow-up.Because of the association of plasmocytoma and amyloidosis, the patient must be followed up because of the possible systemic involvement of the neoplasm and amyloidosis in future.
文摘Pancreatic carcinoma is a debilitating disease and carries a poor prognosis. It is a rare cause of upper gastrointestinal bleeding, even though pancreas, stomach, duodenum and jejunum are adjacent organs. The incidence of pancreatic adenocarcinoma directly invading the gastrointestinal tract leading to gastrointestinal hemorrhage is very low, and most of them present with melena and hematochezia. Here, we describe one unique case manifesting characteristically severe and unremitting hematemesis as an initial presentation of pancreatic adenocarcinoma. This tumor directly invaded the duodenal mucosa as a bleeding protruding tumor mass. Our MEDLINE search has confirmed that this is the first reported case with an initial manifestation of hematemesis from pancreatic adenocarcinoma in Asians.Pancreatic adenocarcinoma directly invading duodenum complicated by hemorrhage can be a rare cause of hematemesis, and clinicians should be reminded of it while they are making differential diagnosis.
