Solitary Plasmacytoma of the Sternum Detected Incidentally by MR Imaging of the Cervical Spine

Nakanishi, Katsuyuki; Kashiwagi, Nobuo; Hamada, Kenichiro; Yagi, Toshinari; Tomita, Yoshihiro

doi:10.2463/mrms.9.227

Cited by 5 publications

(6 citation statements)

References 15 publications

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“…There are a few reports about EMP in the literature but we found only two literature concerning MRI features of nasal EMP. Besides we did not find any case of DWI concerning EMP but however, we came across with one case of plasmacytoma of the sternum that DWI was performed (Nakanishi et al, 2010). The MRI study reveals low to intermediate signal intensity on T1-and moderate to marked increased signal intensity on T2-weighted images.…”

Section: Discussionmentioning

confidence: 97%

A huge nasal extramedullary plasmacytoma: Computerize tomography and diffusion magnetic resonance imaging findings

Elmalı¹,

Polat²,

Aydin³

et al. 2013

jecm

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Article HistoryReceived 11 / 06 / 2012 Accepted 11 / 06 / 2012Extramedullary plasmacytoma (EMP) is an uncommon malignant neoplasm arising outside the bone marrow without clinical evidence of multiple myeloma. EMPs represent less than 1% of all head and neck malignancies. A 51-year-old male had a history of nasal obstruction and epistaxis for several months. Physical examination revealed a fragile and hemorrhagic mass in the nasal cavity. CT scan showed a huge soft tissue mass in the nasal cavity. On the MR images, there was a soft tissue mass which showed marked enhancement after gadolinium administration and restricted diffusion on diffusion weighted images. Histopathological examination results revealed atypical plasma cell infiltration. A diagnosis of EMP was made with these findings. The data of imaging features of nasal EMP is very few in the literature. Therefore, we aimed to present CT and MRI findings of a patient with EMP and contribution of diffusion MRI to the diagnosis.

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Section: Discussionmentioning

confidence: 97%

A huge nasal extramedullary plasmacytoma: Computerize tomography and diffusion magnetic resonance imaging findings

Elmalı¹,

Polat²,

Aydin³

et al. 2013

jecm

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“…The majority of neoplasms of the sternum are metastases. Primary sternal neoplasms are uncommon and are much more frequently malignant than benign ( 2 ). In a study of the Chinese literature that reported 30 cases and reviewed a total of 248 cases of sternal tumors, the most malignant tumors were metastases, followed by myelomas, chondrosarcomas, lymphomas and osteosarcomas; the most benign tumors were chondromas and osteochondromas ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

“…Sternal plasmacytoma usually presents as an osteolytic expansile lesion or a typical ‘punched-out’ lytic lesion on radiological examination ( 15 ). The tumor usually destroys the cortex in several places and invades the soft tissues ( 2 , 4 ). CT may demonstrate a subtle lytic lesion or small soft-tissue masses of the sternal lesion that are not visible by radiography ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

“…CT may demonstrate a subtle lytic lesion or small soft-tissue masses of the sternal lesion that are not visible by radiography ( 16 ). On MR imaging, the tumors usually exhibit a low signal intensity on T1-weighted images and a high signal intensity on T2-weighted images ( 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…The tumors represent ≤5% of all plasma cell neoplasms ( 1 ) and mostly occur in the spine, pelvis, ribs and pectoral girdle ( 1 – 3 ), while rarely occurring in the sternum. Radiologically, SP of the bone typically appears as an osteolytic lesion; the tumor usually destroys the cortex in several places and invades the soft tissues ( 2 , 4 ). In rare cases, the radiological findings may take unusual forms, for example, they can manifest as bony spicules on the surface of the bone, which resemble the appearance of sunrays ( 5 – 12 ).…”

Section: Introductionmentioning

confidence: 99%

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Solitary plasmacytoma of the sternum with a spiculated periosteal reaction: A case report

Zhao

et al. 2014

Oncology Letters

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Solitary plasmacytomas (SPs) represent ≤5% of all plasma cell neoplasms and mostly occur in the spine, pelvis, ribs and pectoral girdle, while rarely occurring in the sternum. The tumors typically appear as osteolytic lesions. In rare cases, SPs can manifest as bony spicules on the surface of the bone. The present study reports the case of a 74 year-old female with an osteolytic tumor localized in the sternum. The tumor displayed extensive bony destruction, with a large quantity of thick straight spicules on the surface of the bone, resembling a sunray in appearance. The imaging, laboratory and pathological examinations of the patient met the diagnostic criteria of SP. The patient was initially treated with radiotherapy at a dose of 45 Gy. Six months later, chemotherapy consisting of vindesine, Adriamycin and dexamethasone was administered. Vindesine and Adriamycin were administered at a dose of 2 and 15 mg/day, respectively on days 1–4 in a 20-day cycle. Dexamethasone was administered at a dose of 20 mg/day on days 1–4, 9–12 and 17–20 in the 20-day cycle. In total, the patient underwent 6 cycles of chemotherapy, with a total duration of 7 months. The patient was followed-up for two years after beginning therapy. At present, the patient is well, without any evidence of progressive disease or multiple myeloma. To the best of our knowledge, this is the first case in the English literature of SP in the sternum, with an unusual sunray periosteal reaction on radiological imaging. The sites of bony spiculation in the lesions that have previously been described in the literature are the mandible, orbit, vertebral body and skull vault. To the best of our knowledge, the current study presents the first case of a SP of the sternum with a unusual spiculated periosteal reaction on radiological imaging to be reported in the English literature.

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Sclerotic multiple myeloma with an unusual sunburst periosteal reaction occurring in the sternum

Zhang

et al. 2014

Skeletal Radiol

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Multiple myeloma is a disseminated neoplastic monoclonal gammopathy that usually affects the skull, clavicle, rib, pelvis, spinal column, and proximal portions of the humerus and femur. The initial manifestation of multiple myeloma in the sternum is rare. The classic radiological presentations of multiple myeloma are multiple "punched-out" areas of bone destruction, expansile lytic lesions, and generalized osteoporosis. Primary sclerotic presentation is rare and occurs in only 3 % of cases. A sclerotic multiple myeloma with a sunburst periosteal reaction occurring in the sternum has not been reported in the English literature. We report a case of sclerotic multiple myeloma of a 49-year-old woman. In the sternum, the lesion displayed extensive sclerosis mixed with mottled lytic areas with a sunburst periosteal reaction occurring in the periphery, which radiologically mimicked an osteosarcoma. Multiple focal areas of sclerosis were also found in the right clavicle, pelvis, multiple ribs, and vertebrae.

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Solitary Plasmacytoma of the Sternum Detected Incidentally by MR Imaging of the Cervical Spine

Cited by 5 publications

References 15 publications

A huge nasal extramedullary plasmacytoma: Computerize tomography and diffusion magnetic resonance imaging findings

A huge nasal extramedullary plasmacytoma: Computerize tomography and diffusion magnetic resonance imaging findings

Solitary plasmacytoma of the sternum with a spiculated periosteal reaction: A case report

Sclerotic multiple myeloma with an unusual sunburst periosteal reaction occurring in the sternum

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