Abstract
Plasmacytoma are extramedullary accumulations of plasma cells. Most extramedullary Plasmacytomas are associated with the upper respiratory tract. The mediastinum is rarely involved. We report a rare case of mediastinal plasmacytoma with multiple myeloma. The patient is 66 year old woman presented with bone pains and mediastinal mass on CT scan and MRI. The preliminary diagnosis of occult lung cancer with mediastinal involvement, and widespread skeletal metastasis was made, although lymphoproliferative disorder along with germ cell tumor was also kept in differentials.The diagnosis of mediastinal plasmacytoma with multiple myeloma was made after extensive investigations
Highlights
Plasmacytoma, a neoplastic proliferation of plasma cells, is a form of plasma cell dyscrasia that may manifest as multiple myeloma, primary amyloidosis, or monoclonal gammopathy of unknown significance
We report a case of mediastinal plasmacytoma with multiple myeloma which is extremely rare in clinical practice
In our case, a diagnosis of multiple myeloma was established within a month after the diagnosis of the mediastinal mass
Summary
Plasmacytoma, a neoplastic proliferation of plasma cells, is a form of plasma cell dyscrasia that may manifest as multiple myeloma, primary amyloidosis, or monoclonal gammopathy of unknown significance. We report a case of mediastinal plasmacytoma with multiple myeloma which is extremely rare in clinical practice. Visit, she started with severe low back pain radiating to lower extremities, nausea, retching, and mild dyspnea She was admitted in the hospital, thorough investigation revealed mediastinal mass on CT scan (Figure 1). The MRI showed 3.9 × 4.2 cms mass in azygoesophageal recess, the pathologic fracture of 8th right rib, abnormal bone marrow signal in multiple areas of right sacroiliac joint, left superior acetabulum, and right greater trochanter. The patient underwent biopsy of mediastinal mass, which was found to be consistent with plasmacytoma (lambda light chain restricted). The patient was put on chemotherapy with bortezomib and dexamethasone and is planned for autologous stem cell transplant (ASCT)
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