Pulmonary Plasmacytoma Research Articles

Plasma Cell Myeloma Initially Presenting as Lung Cancer

Sun Young Cho, M.D., Jae-Heon Jeong, M.D., Woo-In Lee, M.D., Juhie Lee, M.D., Il Ki Hong, M.D., Jin-Tae Suh, M.D., Hee Joo Lee, M.D., Hwi-Joong Yoon, M.D., and Tae Sung Park, M.D.. Ann Lab Med 2013;33:225-8. https://doi.org/10.3343/alm.2013.33.3.225

Solitary pulmonary plasmacytoma

Solitary pulmonary plasmacytoma

Pulmonary plasmacytoma, incidentally detected by myocardial perfusion scintigraphy

Pulmonary plasmacytoma, incidentally detected by myocardial perfusion scintigraphy

Primary Pulmonary Plasmacytoma Presenting as Multiple Lung Nodules

Primary Pulmonary Plasmacytoma Presenting as Multiple Lung Nodules

Extramedullary Plasmacytoma of the Lung – Rather a Disseminated than a Localized Disease? – A Case Report of a Primary Pulmonary Plasmacytoma Showing Distinct Signs of Systemic Spread

Objective: We report an unusual case of a patient with a plasma cell tumor presenting first as a primary pulmonary plasmacytoma (PPP) but then showing distinct signs of systemic spread. Case Summary: A 58-year-old woman presented with an extramedullary plasma cell tumor of the lung with additional affection of lymph nodes above and underneath the diaphragm, without apparent infiltration of the bone marrow by malignant plasma cells, but with evidence of a small proportion of clonal plasma cells in FACS analysis. Due to the fact that the patient showed excretion of lambda light chains in the urine in addition to the solid manifestations on multiple sites and minimal bone marrow involvement, we verified the systemic spread. This is in contrast to primary extramedullary plasmacytoma presenting as solitaire plasma cell tumors mostly occurring in the upper aerodigestive tract or extramedullary myeloma, which describes relapses or extramedullary progression of multiple myeloma emerging in various organs. We herein present all features of a, to our opinion, systemic disease by means of affection pattern, laboratory values, and bone marrow infiltration. Conclusion: This unusual case demonstrates the presentation of an extramedullary plasma cell tumor that appeared as a PPP but showed distinct signs of dissemination as well as uncommon features such as a monoclonal component of IgM type. This example reveales that extramedullary manifestations of plasma cell dyscrasia should be surveyed carefully as they can conceal an underlying systemic disease.

Primary Endobronchial Plasmacytoma Involving Local Lymph Nodes and Presenting with Rare Immunoglobulin G Lambda Monoclonal Gammopathy

Extramedullary plasmacytoma occurring as a primary pulmonary lesion is rare. The present report describes a 42-year-old Chinese man diagnosed with primary pulmonary plasmacytoma following left lower lobectomy. Of note, an extremely rare immunoglobulin G lambda paraprotein was documented in the patient's serum by immunofixation electrophoresis. The patient has been well, showing no local recurrence or multifocal disease during a 15-month follow-up.

A Case of Primary Solitary Pulmonary Plasmacytoma

Most solitary extramedullary plasmacytomas are plasma cell tumors that tend to develop in mucosa-associated lymphoid tissues including the upper respiratory tract. We present a 43-year-old patient who was diagnosed with a solitary plasmacytoma in the lung. Primary plasmacytoma of the lung is exceedingly rare, and the treatment is surgical excision. This malignancy advances to multiple myeloma in a minority of patients. Multiple myeloma is a plasma cell malignancy that typically presents in the bone marrow.

Coexistence of chronic myeloid leukemia and pulmonary plasmacytoma mimicking primary lung cancer

A 61-year-old man was diagnosed with the simultaneous occurrence of chronic myeloid leukemia (CML) and infiltrative intrathoracic plasmacytoma, radiologically mimicking bronchogenic carcinoma. Following the administration of imatinib mesylate (IM; 400mg/day), both hematologic and partial cytogenetic remission of CML were achieved. However, the pulmonary plasmacytoma was persistently aggravated. High-dose dexamethasone was added to the IM therapy because the patient refused radiotherapy to control the aggravated pulmonary plasmacytoma. Finally, he died due to pneumonia and multi-organ failure during concurrent administration of IM and high-dose dexamethasone.

Rapidly Progressive Primary Pulmonary Plasmacytoma

INTRODUCTION: Primary pulmonary plasmocytomas are rarely reported tumors with average progression and treatment over multiple years. We describe a rapidly progressive case of the disease in which the patient responded to unorthodox chemotherapy treatment at late stage.

Primary Pulmonary Plasmacytoma with Diffuse Alveolar Consolidation: A Case Report

Solitary extramedullary plasmacytomas are plasma cell tumors that tend to develop in mucosa-associated lymphoid tissues including the sinonasal or nasopharyngeal regions. Primary plasmacytoma of the lung is exceedingly rare and often presents as a solitary mass or nodule in mid-lung or hilar areas and diagnosed after resection. Herein, we report a case of primary pulmonary plasmacytoma that presented with diffuse alveolar consolidation and diagnosed by transbronchial lung biopsy.

A Case of Multiple Pulmonary Plasmacytomas after Complete Remission of Multiple Myeloma

Extramedullary plasmacytoma (EMP) is a rare disorder that typically occurs in the upper airway. Although the condition rarely arises in the lungs, a few cases have been reported. Here, we report a case of pulmonary plasmacytoma in 66-year-old man, who had been treated with VAD (vincrestine, adriamycin, dexamethasone) chemotherapy for multiple myeloma. The patient had been declared clear of multiple myeloma after 4 cycles of chemotherapy. Three months later, the patient had multiple masses visible on computed tomography (CT) and on positron emission tomography-computed tomography (PET-CT) with hot uptake. Subsequent studies using CT-guided needle biopsy and immunohistochemical stain showed pulmonary plasmacytoma. Bone marrow biopsy, serum, and urine M protein tests were repeated, showing no evidence of multiple myeloma. Pulmonary plasmacytomas, as extramedullary plasmacytomas, were considered an isolated manifestation of multiple myeloma recurrence. We treated the patient with concurrent chemoradiotherapy and the pulmonary plasmacytomas regressed dramatically.

Three Cases of Primary Pulmonary Plasmacytoma

Extramedullary plasmacytoma is a plasma cell malignancy that most commonly occurs in the upper respiratory tract. Plasmocytoma located in the lung is an unusual finding, and in such cases the disease may be confined to the lung and regional lymph nodes or may be disseminated. When only located in the lower respiratory tract (primary pulmonary plasmacytoma), diagnosis is difficult and is usually based on the excised tissue. We present 3 cases, 2 of which were particularly unusual in that diagnosis was confirmed by bronchial biopsy. Other important findings included the detection of paraprotein in the blood and urine of 2 of the patients, and follow-ups over 10 and 15 years without recurrence of the disease in 2 of the cases.

Plasmocitoma bronquial primario: hallazgos en tomografía computarizada

Extramedullary plasmacytomas are malignant neoplasms of the plasmatic cells of the soft tissues. Primary pulmonary plasmacytoma is the rarest type of extramedullary plasmacytoma. The radiologic findings are unspecific and the diagnosis is histologic. Chest CT is useful for confirming its location and planning surgery. We present a case of primary endobronchial plasmacytoma in an adult diagnosed at histology. We describe the findings at plain-film chest X-ray and at CT, and we analyze the usefulness of 3D reconstructions for planning surgery.

Plasmocitoma pulmonar primario: aportación de 3 casos

Extramedullary plasmacytoma is a plasma cell malignancy that most commonly occurs in the upper respiratory tract. Plasmocytoma located in the lung is an unusual finding, and in such cases the disease may be confined to the lung and regional lymph nodes or may be disseminated. When only located in the lower respiratory tract (primary pulmonary plasmacytoma), diagnosis is difficult and is usually based on the excised tissue. We present 3 cases, 2 of which were particularly unusual in that diagnosis was confirmed by bronchial biopsy. Other important findings included the detection of paraprotein in the blood and urine of 2 of the patients, and follow-ups over 10 and 15 years without recurrence of the disease in 2 of the cases.

Solitary pulmonary plasmacytoma: report of two cases

We report two cases of solitary plasmacytoma of the lung. Computed tomographic scan disclosed in case A a solid tissue formation in a cystic pulmonary lesion and in case B a solitary nodule. Suggesting aspergilloma in A and pulmonary malignancy in B diagnostic thoracotomies were performed and the respective findings were resected. In both cases a diagnosis of plasmacytoma was made. Postoperatively multiple myeloma was ruled out. Solitary pulmonary plasmacytoma is a very rare condition and to the best of our knowledge plasmacytoma within a cystic lung lesion has not been described so far. After curative resection treatment the prognosis of these circumscript lesions should be excellent.

Pulmonary and nodal multiple myeloma with a pleural effusion mimicking bronchogenic carcinoma

Multiple myeloma (MM) is a hematological malignancy characterized by the occurrence of plasma cell tumor within the bone marrow. Extramedullary plasmacytomas form a small percentage of plasma cell tumors, and although 80-90% of extramedullary lesions occur in the head and neck, pulmonary plasmacytomas are found to be a very uncommon clinical entity. Hereby, we describe a case of a patient with pulmonary plasmacytoma, who developed nodal and pulmonary MM with a pleural effusion, the radiological appearance of which mimicked bronchogenic carcinoma.

Primary Pulmonary Plasmacytoma

Primary Pulmonary Plasmacytoma

Pulmonary and nodal multiple myeloma mimicking lymphoma

Multiple myeloma is a haematological malignancy characterized by the occurrence of plasma cell tumours within the bone marrow. In advanced multiple myeloma, metastatic deposits outside the bone marrow (extramedullary) are rare. Reported extramedullary sites include the upper respiratory tract and lymph nodes. Parenchymal pulmonary plasmacytoma is exceptionally rare. We describe such a case in a 51-year-old male, who underwent allogenic marrow transplantation. 6 months post-transplantation developing nodal and hilar pulmonary multiple myeloma, the radiological appearances mimicking lymphoma.

Clonal Light Chain Restricted Primary Intrapulmonary Nodular Amyloidosis

Primary intrapulmonary nodular amyloidosis is a rare form of immunoglobulin associated amyloidosis, also falling under the alternative appellation of amyloidoma. Although amyloidomas in other organ sites may be reflective of a localized or more generalized plasma cell dyscrasia, in the context of its presentation in the lung the presumptive basis has long been held to be one of chronic inflammation. We encountered 2 patients with nodular amyloidosis in whom the pathologic examination disclosed the basis to be one of a light chain restricted clonal lymphocytic plasma cell infiltrate, although without morphologic features of coexisting pulmonary lymphoma. These 2 patients serve to underscore the potential categorization of some cases of pulmonary nodular amyloidosis as a form of low grade B cell lymphoproliferative disease.

Primary pulmonary plasmacytoma involving bilateral lungs and marked hypergammaglobulinemia: Differentiation from extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue

A 71-year-old woman was referred to our hospital because of hyperproteinemia and serum M-protein (IgG-λ type). Chest computed tomographic (CT) scan revealed a tumor in each lung and transbronchial lung biopsy was performed. Histopathological examination showed monotonous medullary proliferation of morphologically mature plasma cells. These cells were cIgG+, cIg-λ+, CD20+, CD79a+, CD138+, cIg-κ−, and CD3−. Since there were very few non-neoplastic plasma cells and small lymphocytes in addition to the absence of reactive lymph follicles and fibrosis, the patient was diagnosed as having plasmacytoma. There was no proliferation of plasma cells in the bone marrow. Thus, the lesion was finally characterized as primary pulmonary plasmacytoma. Treatment with melphalan/prednisolone resulted in considerable decrease in the serum IgG level and regression of the pulmonary tumors. The effectiveness of the chemotherapy could confirm our diagnosis, although MALT-type lymphoma with plasmacytic differentiation cannot be completely ruled out.