CT features of abdominal plasma cell neoplasms

Abstract

The aim of this study was to describe the CT features of abdominal plasma cell neoplasms. We reviewed CT imaging findings in 11 patients (seven men, four women; mean age 62 years) with plasma cell neoplasms and abdominal involvement. Helical CT of the entire abdomen and pelvis was performed following intravenous administration of contrast material. Images were analyzed in consensus by two radiologists. Diagnoses were made from biopsy, surgery and/or clinical follow-up findings. Multiple myeloma was found in seven patients and extramedullary plasmacytoma in four patients. All patients with multiple myeloma had multifocal disease with involvement of perirenal space (4/7), retroperitoneal and pelvic lymph nodes (3/7), peritoneum (3/7), liver (2/7), subcutaneous tissues (2/7) and kidney (1/7). In three of the four patients with extramedullary plasmacytoma, a single site was involved, namely stomach, vagina and retroperitoneum. In the fourth patient, a double site of abdominal involvement was observed with rectal and jejunal masses. Plasma cell neoplasm should be considered in the differential diagnosis of single or multiple enhancing masses in the abdomen or pelvis. Abdominal plasma cell neoplasms were most frequently seen as well-defined enhancing masses (10/11).

Neoplastic and Non-neoplastic Proliferative Disorders of the Perirenal Space: Cross-sectional Imaging Findings

“…Plasmacytoma differs from multiple myeloma in that primary lesions may arise outside the bone marrow. Perirenal involvement in multiple myeloma manifests as multiple enhancing masses, whereas plasmacytoma manifests as a solitary enhancing mass with ill-defined margins (54,57,58) (Fig 16).…”

“…Plasma cell neoplasms refers to a spectrum of malignant neoplasms that comprise multiple myeloma, plasmacytoma, and plasma cell leukemia (54). Although multiple myeloma originates in the bone marrow, it spreads to extramedullary sites in approximately 70% of patients (55,56).…”

Extramedullary plasmacytoma of the small intestine: Clinical features, diagnosis and treatment

“…It is required to determine the exact extent of the tumor and its potential for resectability. Abdominal EMP are most frequently seen as well‐defined enlarging masses 64 or local small intestinal wall thickening 21 …”

Patients with Plasma Cell Disorders Examined at Whole-Body Dynamic Contrast-enhanced MR Imaging: Initial Experience

“…For example, we detected hepatic involvement in a patient who had myeloma with clinically nonsecretory disease. Although rare, liver involvement can occur in MM but is usually not sought when only segmental MR imaging is performed (39).…”