Intracranial involvement in plasmacytomas and multiple myeloma: a pictorial essay

Cerase, Alfonso; Tarantino, Annachiara; Gozzetti, Alessandro; Muccio, Carmine Franco; Gennari, Paola; Monti, Lucia; Blasi, Arturo Di; Venturi, Carlo

doi:10.1007/s00234-008-0390-x

Cited by 117 publications

(143 citation statements)

References 33 publications

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“…The latter CNS localization of MM, also termed myelomatous meningitis or central nervous system myelomatosis (CNS-MM) is very uncommon, accounting for about 1% of patients [3][4][5] and is characterized by the presence of neoplastic plasma cells in the cerebrospinal fluid (CSF). 5,6 The pathogenesis of such a phenomenon might be due to the haematogenous spread of plasma cells or of their circulating progenitors. CNS-MM is responsible for a variety of neurological symptoms, which are more frequently represented by confusion, limb weakness, headache, visual disturbances, gait disturbances, speech disturbances.…”

Section: Introductionmentioning

confidence: 99%

Myelomatous Meningitis Evaluated by Multiparameter Flow Cytometry : Report of a Case and Review of the Literature

Marini

Carulli

Lari

et al. 2014

J Clin Exp Hematopathol

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Central nervous system (CNS) involvement in multiple myeloma (MM) is uncommon. Among its possible presentations, leptomeningeal involvement of MM, also termed central nervous system myelomatosis (CNS-MM) is rare and is characterized by the presence of neoplastic plasma cells in the cerebrospinal fluid (CSF). So far, 187 cases of CNS-MM have been reported : the great majority of them were diagnosed by cytological assays and flow cytometry was used in only eight cases. We describe a case of CNS-MM in a 62-year-old woman, previously treated with chemotherapy (VTD) and autologous peripheral blood hematopoietic stem cell transplantation for stage IIIB IgG-l MM. After achieving a very good partial response, the patient showed progression of disease, with an extramedullary localization. During administration of second-line therapy, the patient showed severe neurological symptoms. MRI resulted negative. Diagnosis of CNS-MM was made by multiparameter flow cytometry, which showed the presence of CD56 + plasma cells in a CSF sample, in the absence of plasma cell leukemia. In this paper we also present a review of the eight previous cases of CNS-MM diagnosed by flow cytometry. We found that the application of flow cytometry in cases of MM with neurological symptoms allows a rapid diagnosis of CNS-MM and provides useful information about plasma cell phenotype (including CD56 expression). Some cases of CNS-MM are characterized by normal MRI. In addition, some evidences deriving from the review of literature suggest that CSF monitoring by flow cytometry in such cases might be used to evaluate the efficacy of drugs capable of crossing the blood-brain barrier. 〔J Clin Exp Hematop 54 (2) : 129-136, 2014〕

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Section: Introductionmentioning

confidence: 99%

Myelomatous Meningitis Evaluated by Multiparameter Flow Cytometry : Report of a Case and Review of the Literature

Marini

Carulli

Lari

et al. 2014

J Clin Exp Hematopathol

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“…A sharp tumor border with lack of bony sclerosis is suggestive of solitary plasmacytoma. Metastatic tumors (most commonly from thyroid, renal, or bronchial cancers) are usually lytic lesions (3,5,6). However, metastatic disease should be considered in all patients who experience new neurological finding, even after a prolonged disease-free interval (3).…”

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confidence: 99%

“…Therefore they must be taken into account in cranial osseous and dural lesions (3,8). Definite distinction may be impossible and requires histopathological examination.…”

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confidence: 99%

Dural plasmacytoma mimicking meningioma

Azarpira¹,

Noshadi²,

Pakbaz³

et al. 2012

Turkish Neurosurgery

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Plasma cell tumors are characterized by a monoclonal proliferation of immunoglobulin-secreting plasma cells. Dural infiltration of plasma cells without involvement of the parenchyma, leptomeninges or skull is a rare event. We present a 34-year-old man presenting with hallucination and amnesia. Magnetic resonance imaging revealed a left fronto-temporal mass with a dural tail mimicking meningioma. The mass was excised and histopathological examination revealed sheet of mature plasma cells. The cells were immunoreactive for kappa light chain, MUM1, CD38, and negative for epithelial membrane antigen. There was no recurrence after postoperative radiotherapy. Intracranial involvement from plasmacytoma should be considered in a case of solitary dural mass.KEywoRds: Plasmacytoma, Brain, Dura ÖZPlazma hücresi tümörleri immünglobülin salgılayan plazma hücrelerinin monoklonal proliferasyonuyla karakterizedir. Parankim, leptomeningsler veya kafatası tutulumu olmadan plazma hücrelerinin dural infiltrasyonu nadiren görülür. Halüsinasyon ve amneziyle gelen 34 yaşında bir erkeği sunuyoruz. Manyetik rezonans görüntüleme dural kuyruğu olan ve menenjiyomu taklit eden sol frontotemporal kitleyi ortaya koydu. Kitle eksize edildi ve histopatolojik inceleme matür plazma hücreleri tabakası ortaya koydu. Hücreler kappa hafif zincir, MUM1, CD38 için immünreaktif ve epitelyal membran antijeni için negatifti. Postoperatif radyoterapiden sonra nüks olmadı. Tek başına bir dural kitle varlığında bunun plazmositomun intrakranial yayılımı olabileceği göz önünde bulundurulmalıdır.

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“…The tumor, its products, and the host response to it result in a number of organ dysfunctions and symptoms, including bone pain or fracture, renal failure, susceptibility to infection, anemia, hypercalcemia, and occasionally clotting abnormalities, neurologic symptoms, and manifestations of hyperviscosity. Intracranial lesions of MM commonly involve the cranial vault, the skull base and the orbit [1]. The clivus and petrous regions are far less commonly affected [2].…”

Section: Introductionmentioning

confidence: 99%

Clivus and Dural Involvement in a Case of Multiple Myeloma: A Rare Complication of Multiple Myeloma

Bhartiya

Pachisia

Kapoor

et al. 2015

Indian J Hematol Blood Transfus

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Intracranial involvement in plasmacytomas and multiple myeloma: a pictorial essay

Abstract: The spectrum of clinical and neuroradiological evaluation shows that intracranial involvement from plasmacytoma and multiple myeloma must be taken into account in the differential diagnosis of cranial osseous and meningeal disease.

Cited by 117 publications

References 33 publications

Myelomatous Meningitis Evaluated by Multiparameter Flow Cytometry : Report of a Case and Review of the Literature

Myelomatous Meningitis Evaluated by Multiparameter Flow Cytometry : Report of a Case and Review of the Literature

Dural plasmacytoma mimicking meningioma

Clivus and Dural Involvement in a Case of Multiple Myeloma: A Rare Complication of Multiple Myeloma

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