SOLITARY PRIMARY PULMONARY PLASMACYTOMA: A RARE PRESENTATION

Abstract

TYPE: Abstract TOPIC: Lung Cancer INTRODUCTION: Solitary Primary Pulmonary Plasmacytomas (SPPP) is a rare presentation of solitary intramedullary plasmacytoma. We report a case of Solitary Primary Pulmonary Plasmacytomas with the absence of circulating immunoglobulins which is an extremely rare presentation. CASE PRESENTATION: A 80 year old asymptomatic non-smoker gentleman was evaluated for anemia. Work up for anemia including bone marrow, serum electrophoresis and urine bence jones protein was negative. The whole body PET-CT revealed a 3 x 2 cm solitary lung nodule with increased FDG uptake in the apical segment of the right lower lobe lung. CT guided biopsy was inconclusive. Transbronchial lung biopsy revealed malignant plasma cells with CD138, CD56, V-38 and lambda light chain restrictions. He was diagnosed with Solitary Primary Pulmonary Plasmacytomas. He underwent 25 fractions of 45 Gys radiation with complete resolution. On follow up after 1 year there was no clinical, radiological or biochemical evidence or further extramedullary plasmacytoma. DISCUSSION: Solitary Primary Pulmonary Plasmacytoma is a very rare manifestation of extramedullary plasmacytoma. Diagnosis is by transbronchial lung biopsy, CT guided or ultrasound-guided biopsy and rarely surgical lung biopsy. Treatment options include radiotherapy, surgery and chemotherapy. In select few radiotherapy alone may show an excellent response. CONCLUSIONS: Solitary Primary Pulmonary Plasmacytomas is a very rare condition with a non-specific presentation. A differential of Solitary Primary Pulmonary Plasmacytomas should be considered in patients with solitary hilar lesion with anemia. Radiotherapy alone can have a complete resolution. DISCLOSURE: Nothing to declare. KEYWORD: primary pulmonary plasmacytoma, rare presentation, solitary extramedullary plasmacytoma, Lung cancer