A Rare Case of Extramedullary Plasmacytoma in the Mediastinum.

Abstract

A rare case of extramedullary plasmacytoma in the mediastinum is reported. An 80-year old man was admitted for further examination of a mediastinal tumor. Chest computed tomography (CT) revealed a large mediastinal mass and right interlobar pleural effusion. Needle biopsy under CT guidance established a diagnosis of plasmacytoma. Immunohistochemical staining revealed that the tumor cells were producing monoclonal IgA kappa. Serum immunoelectrophoresis revealed an IgA kappa monoclonal component with a serum concentration of 5,040 mg/ml. The bone marrow aspiration was normal. Bone roentgenogram and bone scintigram showed osteoporosis but no neoplastic lesion.

Answer

“…Mediastinal localisation of plasma-cytoma is very uncommon, usually presenting as a large mass visible on the chest radiograph 3. In this case, EMP was hidden in the middle mediastinum and could only be detected on the chest CT scan.…”

A rare case: extramedullary plasmacytoma of the mediastinum

“…EMP is a rare tumor and mostly detected in the upper aero-digestive tract. It is also very unusual for EMP to occur in mediastinum as a primary solitary lesion [1][2][3][4][5]. Herein we report an extremely unusual presentation of an EMP arising from the posterior mediastinum.…”

“…Extramedullary plasmacytomas (EMP) constitute approximately 3% of the plasma cell neoplasms. It is mostly seen around the 6th decade of life and 3-4 times more in men with respect to women [4]. EMP diagnosis is verified only if there is no evidence of multiple myeloma.…”

Extramedullary Involvement of Lymph Nodes in Multiple Myeloma

“…On the other hand, lymph nodes could be involved in the (10). The extramedullary involvement of lymph nodes is not frequently detected in living patients (3,11,12) but is discovered more often in autopsies (13). An explanation for this could be the absence of symptoms in most cases.…”