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 p...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 infiltration 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 infiltrate 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 findings were consistent with extramedullary plasmocytoma associated 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
BACKGROUND Multiple myeloma is a malignant hematological disease characterized by proliferation of monoclonal plasma cells mainly in the bone marrow.Extraosseous epidural plasmacytoma associated with myeloma arises fr...BACKGROUND Multiple myeloma is a malignant hematological disease characterized by proliferation of monoclonal plasma cells mainly in the bone marrow.Extraosseous epidural plasmacytoma associated with myeloma arises from lymphoid tissue in the epidural space without focal vertebral involvement,and is rare.CASE SUMMARY A 52-year-old woman was diagnosed with kappa subtype nonsecretory multiple myeloma and presented with bilateral arm weakness 11 mo after completing multiple courses of chemotherapy.Spinal magnetic resonance imaging(MRI)showed a posterior C7–T3 epidural mass with spinal cord compression.After five courses of chemotherapy,follow-up MRI showed resolution of cord compression.A 54-year-old man presented with paraplegia 15 mo after a diagnosis of IgD kappa subtype multiple myeloma and completing multiple courses of chemotherapy.He underwent Th11 and L1 laminectomies for tumor resection because MRI showed an epidural mass causing cord compression.Histopathologic examination was consistent with IgD multiple myeloma.The patients have currently survived for 33 mo and 19 mo,respectively.CONCLUSION Isolated extraosseous epidural plasmacytoma associated with multiple myeloma without bony involvement is difficult to diagnose by imaging.Definitive diagnosis requires pathological and immunohistochemical examination.展开更多
Objective: To study the diagnostic method, surgical management and complications of the tracheal malignant tumor, as well as the characteristics of plasmocytoma. Methods: One patient with tracheal plasmocytoma and per...Objective: To study the diagnostic method, surgical management and complications of the tracheal malignant tumor, as well as the characteristics of plasmocytoma. Methods: One patient with tracheal plasmocytoma and pertinent literature were analyzed retrospectively. Results: Resection of the tracheal tumor and reconstruction of the trachea were performed successfully in this case, and the pathological diagnosis is plasmocytoma. Conclusion: The nature, location and extent of tracheal tumor are precisely determined from radiologic studies before resection, as well as tracheal intubation and tracheal anastomosis without tension in operative procedures, are very important for triumphal operation. Even extramedullary plasmocytoma may occur in a lot of organs, but the incidence of it is rare. Both surgery and radiotherapy are cardinal methods for extramedullary plasmocytoma.展开更多
Medical imaging is of crucial importance for diagnosis and initial staging as well as for differentiation of multiple myeloma(MM)from other monoclonal plasma cell diseases.Conventional radiography represents the refer...Medical imaging is of crucial importance for diagnosis and initial staging as well as for differentiation of multiple myeloma(MM)from other monoclonal plasma cell diseases.Conventional radiography represents the reference standard for diagnosis of MM due to its wide availability and low costs despite its known limitations such as low sensitivity,limited specificity and its inability to detect extraosseous lesions.Besides conventional radiography,newer cross-sectional imaging modalities such as whole-body low-dose computed tomography(CT),whole-body magnetic resonance imaging(MRI)and18F-fluorodeoxyglucose(FDG)positron emission tomography(PET)/CT are available for the diagnosis of osseous and extraosseous manifestations of MM.Whole-body low-dose CT is used increasingly,replacing conventional radiography at selected centers,due to its higher sensitivity for the detection of osseous lesions and its ability to diagnose extraosseous lesions.The highest sensitivity for both detection of bone marrow disease and extraosseous lesions can be achieved with whole-body MRI and18F-FDG PET/CT.According to current evidence,MRI is the most sensitive method for initial staging while18F-FDG PET/CT allows monitoring of treatment of MM.There is an evolving role for assessment of treatment response using newer MR imagingtechniques.Future studies are needed to further define the exact role of the different imaging modalities for individual risk stratification and therapy monitoring.展开更多
Introduction: The discovery of peripheral lymphadenopathy is a frequent reason for consultation and hospitalization in Internal Medicine. The aim of this article is to review through three cases the etiologies of chro...Introduction: The discovery of peripheral lymphadenopathy is a frequent reason for consultation and hospitalization in Internal Medicine. The aim of this article is to review through three cases the etiologies of chronic lymphadenopathy rarely reported in a tropical environment. Observations: The first patient is a 62-year-old man who has been infected with HIV-1 for 14 years and who had a multicenter form of Castleman disease. The diagnosis was confirmed after 3 histological lymph nodes. The progression was favorable under Etoposide-based chemotherapy. The second observation is about a 38-year-old woman with a 2-month chronic febrile adenopathy without improvement after anti-tuberculosis treatment. The diagnosis of Kikuchi Fujimoto disease, in its necrotizing form, was confirmed in histology. The evolution was made favorable by the corticosteroid therapy. The third observation is about a 63-year-old woman with an enlargement of groups of lymph nodes, liver, and spleen. This tumoral syndrome was associated to an exudative ascites and a Systemic Inflammatory Response Syndrome (SIRS). The initial diagnosis was a multifocal tuberculosis based on a set of evidence (exudative lymphocytic ascites, epidemiological context and a positive Quantiferon TB test). The first ganglionic histology was not contributory. It was the second ganglionic histology that indicated the diagnosis of lymph node plasmocytoma revealing a myeloma. The patient died of septic shock. Conclusion: In tropical environment, the etiologies of chronic lymphadenopathy are not limited to tuberculosis and malignant haemopathies. Carrying out ganglionic histology is an absolute necessity.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 infiltration 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 infiltrate 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 findings were consistent with extramedullary plasmocytoma associated 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BACKGROUND Multiple myeloma is a malignant hematological disease characterized by proliferation of monoclonal plasma cells mainly in the bone marrow.Extraosseous epidural plasmacytoma associated with myeloma arises from lymphoid tissue in the epidural space without focal vertebral involvement,and is rare.CASE SUMMARY A 52-year-old woman was diagnosed with kappa subtype nonsecretory multiple myeloma and presented with bilateral arm weakness 11 mo after completing multiple courses of chemotherapy.Spinal magnetic resonance imaging(MRI)showed a posterior C7–T3 epidural mass with spinal cord compression.After five courses of chemotherapy,follow-up MRI showed resolution of cord compression.A 54-year-old man presented with paraplegia 15 mo after a diagnosis of IgD kappa subtype multiple myeloma and completing multiple courses of chemotherapy.He underwent Th11 and L1 laminectomies for tumor resection because MRI showed an epidural mass causing cord compression.Histopathologic examination was consistent with IgD multiple myeloma.The patients have currently survived for 33 mo and 19 mo,respectively.CONCLUSION Isolated extraosseous epidural plasmacytoma associated with multiple myeloma without bony involvement is difficult to diagnose by imaging.Definitive diagnosis requires pathological and immunohistochemical examination.
文摘Objective: To study the diagnostic method, surgical management and complications of the tracheal malignant tumor, as well as the characteristics of plasmocytoma. Methods: One patient with tracheal plasmocytoma and pertinent literature were analyzed retrospectively. Results: Resection of the tracheal tumor and reconstruction of the trachea were performed successfully in this case, and the pathological diagnosis is plasmocytoma. Conclusion: The nature, location and extent of tracheal tumor are precisely determined from radiologic studies before resection, as well as tracheal intubation and tracheal anastomosis without tension in operative procedures, are very important for triumphal operation. Even extramedullary plasmocytoma may occur in a lot of organs, but the incidence of it is rare. Both surgery and radiotherapy are cardinal methods for extramedullary plasmocytoma.
文摘Medical imaging is of crucial importance for diagnosis and initial staging as well as for differentiation of multiple myeloma(MM)from other monoclonal plasma cell diseases.Conventional radiography represents the reference standard for diagnosis of MM due to its wide availability and low costs despite its known limitations such as low sensitivity,limited specificity and its inability to detect extraosseous lesions.Besides conventional radiography,newer cross-sectional imaging modalities such as whole-body low-dose computed tomography(CT),whole-body magnetic resonance imaging(MRI)and18F-fluorodeoxyglucose(FDG)positron emission tomography(PET)/CT are available for the diagnosis of osseous and extraosseous manifestations of MM.Whole-body low-dose CT is used increasingly,replacing conventional radiography at selected centers,due to its higher sensitivity for the detection of osseous lesions and its ability to diagnose extraosseous lesions.The highest sensitivity for both detection of bone marrow disease and extraosseous lesions can be achieved with whole-body MRI and18F-FDG PET/CT.According to current evidence,MRI is the most sensitive method for initial staging while18F-FDG PET/CT allows monitoring of treatment of MM.There is an evolving role for assessment of treatment response using newer MR imagingtechniques.Future studies are needed to further define the exact role of the different imaging modalities for individual risk stratification and therapy monitoring.
文摘Introduction: The discovery of peripheral lymphadenopathy is a frequent reason for consultation and hospitalization in Internal Medicine. The aim of this article is to review through three cases the etiologies of chronic lymphadenopathy rarely reported in a tropical environment. Observations: The first patient is a 62-year-old man who has been infected with HIV-1 for 14 years and who had a multicenter form of Castleman disease. The diagnosis was confirmed after 3 histological lymph nodes. The progression was favorable under Etoposide-based chemotherapy. The second observation is about a 38-year-old woman with a 2-month chronic febrile adenopathy without improvement after anti-tuberculosis treatment. The diagnosis of Kikuchi Fujimoto disease, in its necrotizing form, was confirmed in histology. The evolution was made favorable by the corticosteroid therapy. The third observation is about a 63-year-old woman with an enlargement of groups of lymph nodes, liver, and spleen. This tumoral syndrome was associated to an exudative ascites and a Systemic Inflammatory Response Syndrome (SIRS). The initial diagnosis was a multifocal tuberculosis based on a set of evidence (exudative lymphocytic ascites, epidemiological context and a positive Quantiferon TB test). The first ganglionic histology was not contributory. It was the second ganglionic histology that indicated the diagnosis of lymph node plasmocytoma revealing a myeloma. The patient died of septic shock. Conclusion: In tropical environment, the etiologies of chronic lymphadenopathy are not limited to tuberculosis and malignant haemopathies. Carrying out ganglionic histology is an absolute necessity.
