What is a Plasmacytoma?

Plasmacytoma is a tumor of plasma cells of bony or soft tissue and can occur anywhere in the body without evidence of systemic disease.

What is the Pathology of Plasmacytoma?

The pathology of plasmacytoma is:

-Etiology: The cause of plasmacytoma is unknown. It is suggested that it may be caused by inhalation of chemicals, chronic stimulation, an overdose of irradiation, viral infection, and genetic disorders in the reticuloendothelial system.

-Genes involved: CCND1 gene.

-Pathogenesis: The sequence of events that lead to plasmacytoma show that losses of chromosome 13 arm 1p and 14q and gains in chromosome 19 arm 1q and 9q which play a role in tumorigenesis of plasmacytomas.

-Histology: The histology associated with plasmacytoma shows monoclonal cell infiltrates in one or more lytic bone lesions or extramedullary tissue.

Multiple Myeloma. Aspiration cytology smear of a case plasmacytoma in 4 cm diameter chest wall mass in a 69 year male patient. (MGG stain, ×440). Cytology of plasma cell rich effusion in cases of plasma cell neoplasm. Journal of Cytology / Indian Academy of Cytologists. Not altered. CC.
Plasmacytoma_Microscopy. Histologic examination of the pleural fluid (A), mediastinal mass (B and C), and bone marrow (D, E, and F). (A) Cytospin analysis of pleural fluid shows increased plasma cells with eccentric nuclei and abundant basophilic cytoplasm, consistent with myelomatous pleural effusion (Wright-Giemsa stain, ×200). (B) The histologic examination of mediastinal plasmacytoma reveals diffuse infiltration of mature plasma cells (hematoxylin and eosin stain, ×200). (C) Immunohistochemical staining of mediastinal plasmacytoma shows CD138 positivity (×1,000). (D) Bone marrow aspiration shows moderate proliferation of neoplastic plasma cells, consistent with plasma cell myeloma (Wright-Giemsa stain, ×1,000). (E and F) Immunohistochemical staining of bone marrow shows monoclonal proliferation of lambda-restricted plasma cells (kappa [E] and lambda [F] stains, ×200). A case of salivary-type amylase-producing multiple myeloma presenting as mediastinal plasmacytoma and myelomatous pleural effusion. Ok SJ, Kim IS, Lee EY, Kang JE, Lee SM, Song MK - Annals of laboratory medicine (2014). Not altered. CC.
Plasmacytoma Endoscopy. Ileocecal plasmacytoma. Gross appearance of polyp during the diagnostic colonoscopy for our case. The polyp measured nearly 4 cm and had an obvious ulceration on its surface as shown. It had a thin, long stalk and so was removed by hot snare. Discovery of a rare ileocecal plasmacytoma. Gabriel EM, Savu M - Journal of surgical case reports (2014). Not altered. CC.
Plasmacytoma Histology. Histology of the ileocecal plasmacytoma. Pathology revealed that the polyp was an extramedullary plasmacytoma. The top left shows H&E staining and the bottom left shows increased magnification, illustrating classic cartwheel nuclei. The top right and bottom right show special staining for either the kappa or lambda light chain, respectively. Here the polyp specifically stains for the kappa light chain, indicating that it comprised a monoclonal population of plasma cells. Discovery of a rare ileocecal plasmacytoma. Gabriel EM, Savu M - Journal of surgical case reports (2014). Not altered. CC.
Plasmacytoma Histology H&E. Micrograph of a plasmacytoma. H&E stain. The micrograph shows abundant (malignant) plasma cells with the occasional Mott cell, a plasma cell with an intracytoplasmic Russell bodies (an eosinophilic uniformly staining membrane bound body which contains immunoglobulin). Other features of plasmacytomas (not apparent on the image) are: a prominent perinuclear hof (large Golgi bodies), and Dutcher bodies (intranuclear inclusions). The plasma cells have the characteristic "clockface nuclei". Multiple myeloma (which is diagnosed using several clinical criteria) is, histologically, a plasmacytoma. Related images Uncropped. Cropped. Courtesy of Nephron. Not altered. CC.
Plasmacytoma_Serum_protein_electrophoresis_normal_and_paraprotein. An example serum protein electrophoresis. Albumin (orange), alpha-1 (pink), alpha-2 (blue), beta-1 (yellow), beta-2 (green) and gamma (red) peaks are shown. Antibodies are mostly found in the gamma region. The top image shows serum protein electrophoresis from a normal individual with polyclonal antibodies (no peaks in the gamma region). The bottom image a monoclonal antibody present (paraprotein), which presents as a peak in the gamma region. Courtesy of Simona Caulton. Not altered. CC.
Plasmacytoma. Micrograph of a plasmacytoma. H&E stain. The micrograph shows abundant (malignant) plasma cells with the occasional Mott cell, a plasma cell with intracytoplasmic Russell bodies (an eosinophilic uniformly staining membrane bound body which contains immunoglobulin). Courtesy of Nephron. Not Altered. CC.

How does Plasmacytoma Present?

Patients with plasmacytoma typically are males more than females and present at age range of 55 to 60 years. The symptoms, features, and clinical findings associated with plasmacytoma include pain in the affected bone, back pain and other consequences of the bone lesion.

How is Plasmacytoma Diagnosed?

Plasmacytoma is diagnosed by lesional biopsy or fine needle aspiration techniques.

How is Plasmacytoma Treated?

Plasmacytoma is treated with surgery, radiotherapy and chemotherapy.

What is the Prognosis of Plasmacytoma?

The prognosis of plasmacytoma is poor. The causes of poor prognosis include local recurrence, incomplete resection with functional damage, local lymph node metastasis, progression to multiple myeloma, or new bone lesions formation with multiple myeloma.