Abstract
Solitary extramedullary plasmacytoma (EMP) of the spleen is a rare condition. The present study describes the case of a 23-year-old female with an extremely rare solitary EMP of the spleen. Upon examination, the tumor demonstrated unusual and notable multiple-phase spiral computed tomography (CT) findings. The lesion was a solitary, well-defined mass, with areas of variable splenic necrosis and cystic degeneration. Contrast-enhanced CT revealed progressive enhancement of the lesion in the cystic wall, internal septa and solid portion, a finding that has not previously been described. The patient underwent a splenectomy and recovered without complications. No evidence of tumor recurrence has occurred during the past two years of follow-up. To the best of our knowledge, this is the first study to examine the CT findings of a solitary EMP of the spleen. The study aimed to investigate the imaging features of solitary EMP, in particular the multiple-phase spiral CT findings, and raise awareness of the disease to reduce misdiagnoses.
Highlights
Solitary extramedullary plasmacytoma (EMP) is a rare plasma cell neoplasm that occurs most frequently in head and neck soft‐tissue regions, with the nasopharynx, nasal cavity and paranasal sinuses most commonly affected [1]
SP is classified according to location as either solitary plasmacytoma of the bone (SPB) or EMP [5]
The majority of cases of SPB occur in areas of the axial skeleton, such as the vertebrae and the skull [5], whereas cases of EMP are usually observed in the head and neck
Summary
Solitary extramedullary plasmacytoma (EMP) is a rare plasma cell neoplasm that occurs most frequently in head and neck soft‐tissue regions, with the nasopharynx, nasal cavity and paranasal sinuses most commonly affected [1]. No studies examining the computed tomography (CT) findings of splenic EMP have been published. The pre‐contrast CT revealed that the spleen was enlarged and contained a solitary, well‐defined mass, with areas of variable cystic degeneration and necrosis. The mean CT attenuation value of the solid portion was 39 HU, while the values observed for the areas of necrosis and cystic degeneration were 21‐23 HU (Fig. 1A). Following a bolus injection of the nonionic contrast agent iopamidol, the cystic wall, internal septa and solid portion of the spleen demonstrated mild enhancement, with a 43 HU attenuation value during the hepatic artery phase. The immunohistochemical staining was positive for λ‐light chains, but negative for κ‐light chains (Fig. 2B and C) These findings were consistent with the diagnostic criteria of plasmacytoma. Post‐operatively, the patient recovered without complications, and no evidence of tumor recurrence has occurred during the past two years of follow‐up
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