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1.
Vet Immunol Immunopathol ; 215: 109903, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31420067

RESUMO

Sensitivity of clonality analysis based on immunoglobulin heavy chain (IGH) in canine cutaneous plasmacytoma is lower than that in diffuse large B cell lymphoma (DLBCL) because of somatic hypermutation occurring at the IGH locus. Therefore, this study aimed to improve the sensitivity of clonality analysis for canine cutaneous plasmacytoma. To achieve this, clonality analysis based on the immunoglobulin kappa chain (IGK) locus was established. Sensitivity and specificity were examined in genomic DNA extracted from formalin-fixed paraffin-embedded sections of cutaneous plasmacytomas, DLBCLs, and lymph nodes without lymphoma. Forward primers were designed based on the IGKV genes, and reverse primers were designed based on the IGKJ genes and kappa deleting element (Kde). Analysis using IGKV and IGKJ primers demonstrated clonality in 24 of 29 cutaneous plasmacytomas (82.8%), while analysis with primers for IGKV and Kde showed clonality in 16 of 29 cases (55.2%). In DLBCL, the IGKV and IGKJ primer set yielded clonality in 18 of 23 cases (78.3%), and the IGKV and Kde primer set yielded 9 of 23 cases (39.1%). No clonal results were obtained from 23 lymph nodes without lymphoma. Sensitivity of the IGKV and IGKJ primer set was significantly higher than that of the IGH primers reported previously. Thus, clonality analysis based on the IGK locus can be utilized for canine B cell tumors. In conclusion, clonality testing based on IGH and IGK may be beneficial as an adjunct tool for diagnosis of canine B cell tumors including cutaneous plasmacytoma.


Assuntos
Doenças do Cão/imunologia , Cadeias kappa de Imunoglobulina/genética , Linfoma de Células B/veterinária , Plasmocitoma/veterinária , Neoplasias Cutâneas/veterinária , Animais , Células Clonais , DNA de Neoplasias , Doenças do Cão/genética , Cães , Genes de Imunoglobulinas , Região de Junção de Imunoglobulinas/genética , Região Variável de Imunoglobulina/genética , Linfonodos/imunologia , Linfoma de Células B/genética , Linfoma de Células B/imunologia , Plasmocitoma/genética , Plasmocitoma/imunologia , Plasmocitoma/patologia , Sensibilidade e Especificidade , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/imunologia
2.
Medicine (Baltimore) ; 98(27): e16087, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277104

RESUMO

Plasmacytoma variant translocation 1 (PVT1) is highly expressed in a variety of cancer tissues and is related to the clinicopathological features and prognosis. However, the prognostic value of PVT1 is still controversial. Therefore, this systematic evaluation and meta-analysis were performed to evaluate the relationship between PVT1 expression and clinicopathological features.PubMed, EMBASE, Web of science, and Cochrane library databases were searched for literature collection according to inclusion criteria and exclusion criteria. The pooled hazard ratios (HRs) or odds ratios (ORs) were used to evaluate the association between PVT1 expression and overall survival, tumor size, tumor-node-metastasis (TNM) stage, lymph node metastasis, and distant metastasis.A total of 39 articles including 3974 patients were included in the study. The results showed that the expression of PVT1 was closely related to the overall survival rate of cancers (HR = 1.64, 95% confidence interval [CI]: 1.50-1.78, P < .000001). Subgroup analysis showed that the high expression of PVT1 was closely related to the low overall survival rate of patients with clear cell renal cell carcinoma, breast cancer, cervical cancer, colon cancer, epithelial ovarian cancer, gastric cancer, lung cancer, and osteosarcoma. In addition, the high expression of PVT1 was positively correlated with tumor size (OR = 1.50, 95% CI: 1.14-1.96, P = .004), TNM stage (OR = 3.39, 95% CI: 2.73-4.20, P < .00001), lymph node metastasis (OR = 2.60, 95% CI: 1.76-3.84, P < .00001), and distant metastasis (OR = 2.94, 95% CI: 1.90-4.56, P < .00001).PVT1 could serve as a marker for the size, TNM stage, metastasis, and prognosis of different type of cancers.


Assuntos
Metástase Neoplásica/genética , Neoplasias/genética , Plasmocitoma/genética , RNA Longo não Codificante/metabolismo , Biomarcadores Tumorais/metabolismo , Regulação Neoplásica da Expressão Gênica , Humanos , Estadiamento de Neoplasias , Neoplasias/mortalidade , Estudos Observacionais como Assunto , Análise de Sobrevida
3.
J Craniofac Surg ; 30(5): e411-e413, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31299796

RESUMO

Solitary plasmacytoma is an abnormal proliferation of B-lymphoid cells that involves a single bone. It mainly affects the axial skeleton; the jaw localization is a rare condition. The authors present a case of a 70-year-old female patient with a radiolucency of the angle of the mandible later diagnosed as solitary plasmacytoma.


Assuntos
Neoplasias Ósseas/diagnóstico , Plasmocitoma/diagnóstico , Idoso , Diagnóstico Precoce , Feminino , Humanos , Mandíbula
4.
Ann Hematol ; 98(10): 2463-2465, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31240468
5.
Clin Nucl Med ; 44(7): 596-598, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31135522

RESUMO

MRI and F-FDG PET/CT were performed on a 37-year-old man who was suspected with malignant spinal tumor on x-ray examination. An FDG-avid expansile lytic lesion was found in his T12 vertebra. The lesion showed a characteristic "mini-brain" appearance on MRI and CT. This extremely high specificity sign and consistent manifestation on PET image indicated plasmacytoma as the most optimal diagnosis. But finally, a giant cell tumor was confirmed after surgery. The case cautions that the specificity of the diagnostic characteristics of "mini-brain" sign for plasmacytoma or multiple myeloma may not be as high as previously reported.


Assuntos
Tumores de Células Gigantes/diagnóstico por imagem , Mieloma Múltiplo/diagnóstico por imagem , Plasmocitoma/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias da Medula Espinal/diagnóstico por imagem , Adulto , Diagnóstico Diferencial , Fluordesoxiglucose F18 , Tumores de Células Gigantes/patologia , Humanos , Masculino , Mieloma Múltiplo/patologia , Plasmocitoma/patologia , Compostos Radiofarmacêuticos , Neoplasias da Medula Espinal/patologia
6.
Radiat Oncol ; 14(1): 63, 2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-30987659

RESUMO

BACKGROUND: Patients with plasma-cell neoplasia usually suffer from systemic disease, although a minority (< 5%) may present with solitary involvement of bone or soft tissue (extramedullary plasmacytoma (EMP)). Radiotherapy (RT) is a state-of-the-art treatment for these tumors offering long term curation. METHODS AND MATERIALS: Between January 2005 and January 2017, twenty-seven patients underwent RT at our institution. The aim of this study was to analyse the effectiveness of various RT doses for different forms of EMP. RESULTS: A total of 33 radiation courses were administered to 27 patients with a median age of 56 years. The median RT dose was 45 Gy (range: 12-55.8). The local control rate was 76% (93% for primary EMP vs. 61% for the secondary EMP lesions; P < 0.05). A complete response (CR) rate to local RT was achieved for 42% lesions (67% for primary EMP vs. 22% for the secondary EMP lesions; P < 0.01). The overall response rate (ORR) for the EMP lesions treated with high-dose regimens (> 45 Gy) versus low-dose regimens (≤ 45 Gy) was 87% versus 67%, respectively (P = 0.2). The median survival with high-dose RT group was significantly longer (P = 0.02). In subgroups analysis, primary EMP patients treated with high-dose RT had a non-significant higher ORR (100% vs. 80%, respectively; P = 0.3,) longer duration of LC (P = 0.3) with a longer survival (P = 0.05) than patients in low-dose group. No significant difference has been detected in secondary EMP patients treated with high-dose RT regarding ORR (60% vs. 62%, respectively; P = 1), and survival (P = 0.4). CONCLUSION: RT is an efficacious treatment modality in the treatment of EMP. A radiation dose ≤45 Gy confer a comparable CR rate to high-dose regimens and appears to be an effective treatment for controlling local EMP progression. Radiation dose-escalation may be beneficial for particular subgroups of patients.


Assuntos
Neoplasias de Cabeça e Pescoço/mortalidade , Plasmocitoma/mortalidade , Planejamento da Radioterapia Assistida por Computador/métodos , Radioterapia de Intensidade Modulada/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Masculino , Pessoa de Meia-Idade , Órgãos em Risco/efeitos da radiação , Plasmocitoma/patologia , Plasmocitoma/radioterapia , Prognóstico , Dosagem Radioterapêutica , Radioterapia de Intensidade Modulada/métodos , Taxa de Sobrevida
8.
Clin Nucl Med ; 44(7): e461-e464, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30985424

RESUMO

Multiple-myeloma (MM) is a malignant plasma cell proliferation disorder and the second most common blood malignancy after non-Hodgkin lymphoma. The chemokine (CXCR-4) receptor analogues are the newer agents being postulated for myeloma imaging and have shown good diagnostic performance. We report a case of plasmacytoma with suspicious renal cell carcinoma, in whom Ga CXCR-4 PET/CT revealed tracer-avid lesion in the left perinephric region. PET/CT-guided biopsy from the tracer-avid lesion revealed plasmacytoma. PET/CT-imaging and guided biopsy using Ga CXCR4 receptor ligand, proved its usefulness for accurate localization of the culprit lesion and helped in definitive management of the patient.


Assuntos
Carcinoma de Células Renais/diagnóstico por imagem , Neoplasias Renais/diagnóstico por imagem , Plasmocitoma/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Receptores CXCR4/metabolismo , Idoso , Diagnóstico Diferencial , Fluordesoxiglucose F18 , Radioisótopos de Gálio , Humanos , Masculino , Compostos Organometálicos , Compostos Radiofarmacêuticos
9.
Medicine (Baltimore) ; 98(17): e15443, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31027147

RESUMO

RATIONALE: Plasmacytoma as the 1st presentation of skull tumors is a rare disorder. When it is combined with brain trauma or dramatic changes in intracranial pressure, patients are more prone to misdiagnosis. PATIENT CONCERNS: A 67-year-old woman complaining of a headache presented with a history of head trauma for the past 1 hour. Emergency head computed tomography initially suggested an epidural hematoma. DIAGNOSIS: Emergency surgery was performed to remove the intracranial hematoma, but a tumor-like mass was found during surgery, and pathologic assessment confirmed plasmacytoma. Surgery was difficult because of bleeding. The tumor was radically removed. INTERVENTIONS AND OUTCOMES: The patient underwent whole-brain radiotherapy and chemotherapy. She died 40 months after the surgery. LESSONS: Epidural lesions found after a head injury may be assumed to be an epidural hematoma, leading to unnecessary surgery. Diseases such as hematomas, meningiomas, eosinophilic granulomas, bone metastases, and osteosarcomas must be considered.


Assuntos
Traumatismos Craniocerebrais/diagnóstico , Hematoma Epidural Craniano/diagnóstico , Plasmocitoma/diagnóstico , Neoplasias Cranianas/diagnóstico , Idoso , Traumatismos Craniocerebrais/complicações , Traumatismos Craniocerebrais/terapia , Diagnóstico Diferencial , Evolução Fatal , Feminino , Hematoma Epidural Craniano/cirurgia , Humanos , Plasmocitoma/patologia , Plasmocitoma/terapia , Neoplasias Cranianas/patologia , Neoplasias Cranianas/terapia
11.
BMJ Case Rep ; 12(3)2019 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-30846451

RESUMO

Extramedullaryplasmacytoma (EMP) represents a peculiar and typically progressive malignancy that can originate outside the bone marrow. Primary pulmonary plasmacytoma (PPP) is a rare subset of EMP, confined to the lung. A 55-year-old man, diabetic, non-smoker presented to our clinic with a right chest wall swelling. A routine chest radiograph showed a well-circumscribed opacity in the right upper lung zone. A CT of the chest revealed a large right upper lobe mass with extensive local infiltration. Biopsy and immunohistochemical evaluation led to a diagnosis of PPP. Screening for multiple myeloma was negative. Serum immunofixation showed an IgG lambda monoclonal gammopathy, found in a minority of PPP patients. In view of disease extent, treatment with chemotherapy and radiotherapy was initiated. The patient is currently in out patient follow-up and has shown a favourable response to the treatment with a considerable decrease in serum IgG levels.


Assuntos
Neoplasias Pulmonares/patologia , Neoplasias de Plasmócitos/patologia , Paraproteinemias/patologia , Plasmocitoma/patologia , Assistência ao Convalescente , Quimiorradioterapia/métodos , Humanos , Imunoglobulina G/sangue , Pulmão/diagnóstico por imagem , Pulmão/patologia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/imunologia , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/diagnóstico , Neoplasias de Plasmócitos/diagnóstico , Neoplasias de Plasmócitos/imunologia , Paraproteinemias/sangue , Paraproteinemias/imunologia , Plasmocitoma/tratamento farmacológico , Plasmocitoma/metabolismo , Plasmocitoma/radioterapia , Doenças Raras , Resultado do Tratamento
12.
Gan To Kagaku Ryoho ; 46(1): 100-102, 2019 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-30765654

RESUMO

A 78-year-oldwoman was referredfor exertional dyspnea. Severe anemia(Hb 4.2 g/dL)was detected, and upper endoscopy revealeda giant ulcer at the posterior wall of the gastric body. Computedtomography showeda mass protruding from the gastric wall, suggestive of a submucosal tumor. Although biopsy did not confirm a diagnosis, we performed distal gastrectomy to control the bleeding. The pathological findings and systemic examination confirmed a diagnosis of extramedullary plasmacytoma of the stomach. Plasmacytoma is a tumor of the bone marrow derived from plasma cells that mature from B cells. The frequency of extramedullary plasmacytoma for all plasmacytoma is about 5% and plasmacytoma derived from the stomach occurs in approximately 2%of these cases. Complete resection with lymph node dissection according to the surgical treatment of gastric cancer is recommended. Large tumors, such as that in the present case, may have a poor prognosis; thus, careful follow-up is required for the early detection of recurrence. We report a case of extramedullary plasmacytoma of the stomach with a literature review.


Assuntos
Anemia , Plasmocitoma , Neoplasias Gástricas , Idoso , Anemia/etiologia , Feminino , Humanos , Recidiva Local de Neoplasia , Plasmocitoma/complicações , Plasmocitoma/diagnóstico , Neoplasias Gástricas/complicações , Neoplasias Gástricas/diagnóstico
13.
Pol Merkur Lekarski ; 46(271): 42-44, 2019 Jan 28.
Artigo em Polonês | MEDLINE | ID: mdl-30810115

RESUMO

Extramedullary plasmacytoma (EMP) is the localized plasma cell neoplasm, that arise in tissues other than bone. The upper respiratory tract and the oral cavity are the most common sites for EMP location. EMPs of the thyroid gland are extremely rare and thus little is known about their behavior compared to other EMPs. CASE REPORT: 68-year-old female patient was admitted to the Department of General, Gastroenterological and Endocrine Surgery due to suspicion of neoplastic proliferation of unknown character within the thyroid gland. Computed tomography (CT) of the neck and chest showed tumor modeling adjacent anatomical structures. Cytological presentation obtained by fine needle aspiration biopsy was classified as category V according to the Bethesda system ("suspicious for malignancy"). The recognition of the lymphoma was suggested. The histopathological examination result of the specimens obtained from surgical biopsy was ambiguous. The patient was transferred to the Neurosurgical Department to continue the diagnostic process due to a presence of tumor within Th5 vertebral body. Percutaneous biopsy and magnetic resonance imaging (MRI) was performed, revealing metastatic character of the lesion and presence of plasma cells. After transferring patient back to surgical ward thyroidectomy was performed. Postoperative histopathological and immunohistochemisty analysis revealed EMP with highly immature morphology. Afterwards patient was admitted to Hematology Clinic in order to establish an adjuvant therapy. CONCLUSIONS: EMP is a very rare form of the primary thyroid malignancy, what makes it difficult to recognize. However, in the differential diagnosis of the thyroid tumors, EMP should be always considered.


Assuntos
Plasmocitoma , Neoplasias da Glândula Tireoide , Idoso , Biópsia por Agulha Fina , Feminino , Humanos , Plasmocitoma/diagnóstico , Plasmocitoma/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
15.
J Neurooncol ; 142(2): 263-272, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30617445

RESUMO

PURPOSE: We aim to delineate the clinical characteristics of patients with primary intracranial solitary plasmacytoma (PISPC) and prognostic factors for their outcomes. METHODS: This study retrospectively reviewed 17 patients with PISPC from our center and an additional 70 cases of PISPC published previously to analyze outcome predictors. RESULTS: The entire cohort included 38 (43.7%) males and 49 (56.3%) females with a mean age of 54 years. Skull base tumors were found in 49 (56.3%) patients. Gross total resection (GTR) was achieved in 31 (35.6%) patients. Postoperative adjuvant treatments, including radiotherapy (RT) alone, chemotherapy (CMT) alone, and RT + CMT were administered in 49 (56.3%) patients, 3 (3.5%) patients, and 16 (18.4%) patients, respectively. After a median follow-up of 24 (mean 42.4) months, the 5-year disease progression-free survival (PFS), recurrence-free survival (RFS), multiple myeloma (MM)-free survival (MMFS), and overall survival (OS) were 52.9%, 76.2%, 69.6%, and 76.1%, respectively. Multivariate analysis unveiled that a skull base tumor location (HR 2.395, p = 0.040) and no RT (HR 3.115, p = 0.004) were negative prognostic factors for PFS, no RT (HR 10.526, p = 0.003) for RFS, each 1-year increase in age (HR 1.039, p = 0.049) for MMFS, and increasing age (HR 1.052, p = 0.043) and CMT (HR 6.022, p = 0.005) were risk factors for OS. However, GTR did not benefit the aforementioned outcomes. CONCLUSION: For patients with presumed PISPC, a biopsy followed by RT is recommended for skull base PISPC. However, the role of CMT is still not clear. Our findings need to be verified in a larger prospective cohort in the future. Systematic review registration number CRD42018098782.


Assuntos
Plasmocitoma/diagnóstico por imagem , Plasmocitoma/cirurgia , Neoplasias da Base do Crânio/diagnóstico por imagem , Neoplasias da Base do Crânio/cirurgia , Adulto , Fatores Etários , Idoso , Terapia Combinada , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Plasmocitoma/epidemiologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Base do Crânio/diagnóstico por imagem , Neoplasias da Base do Crânio/epidemiologia
16.
Medicine (Baltimore) ; 98(4): e14235, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30681607

RESUMO

RATIONALE: Extramedullary plasmacytomas (EMP) are tumors composed by a monoclonal population of plasma cells that arise in extraosseus tissues, occupying <5% of all plasma cell neoplasms. Gastrointestinal solitary extramedullary plasmacytoma is rare, just comprises about 5% of all EMPs. The most common site is small intestine. The gastric incidence is much rare and especially the plasmablastic plasmacytoma in the stomach. PATIENT CONCERNS: A 65-year-old man had an epigastric discomfort and mass for about 2 months. Gastroscopy revealed a malignant tumor in the gastric body. Abdomen computed tomography (CT) showed that the gastric cavity was filled, and the irregular soft tissue shadow was seen in the greater curvature, and the enhancement was obvious. To get more tissue, we conducted stomach puncture biopsy. Pathology showed small-round cell malignant tumors. And immunohistochemical examinations revealed that the tumor tend to be a plasma cell tumor. DIAGNOSIS: Gastric plasma cell tumor. INTERVENTIONS: Distal gastrectomy was performed to treat the tumor. OUTCOMES: In addition to ascites caused by hypoproteinemia, there were no postoperative complications. Postoperative pathologic report showed plasmablastic plasmacytoma. Histopathologic examination of the specimen revealed plasmablastic plasmacytoma originating in the stomach with transmural extension, but without lymph node metastasis. The patient is regularly followed up at a postoperative clinic and is doing well, and at present there is no plan for adjuvant treatment. LESSONS: Surgical resection is good option for gastrointestinal EMP.


Assuntos
Plasmocitoma/patologia , Neoplasias Gástricas/patologia , Idoso , Humanos , Imunocompetência , Masculino , Plasmocitoma/imunologia , Neoplasias Gástricas/imunologia
17.
Int J Mol Sci ; 20(3)2019 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-30678047

RESUMO

Bone marrow angiogenesis plays an important role in the pathogenesis and progression of hematological malignancies. It is well known that tumor microenvironment promotes tumor angiogenesis, proliferation, invasion, and metastasis, and also mediates mechanisms of therapeutic resistance. An increased number of mast cells has been demonstrated in angiogenesis associated with hematological tumors. In this review we focused on the role of mast cells in angiogenesis in human plasma cell malignancies. In this context, mast cells might act as a new target for the adjuvant treatment of these tumors through the selective inhibition of angiogenesis, tissue remodeling and tumor-promoting molecules, permitting the secretion of cytotoxic cytokines and preventing mast cell-mediated immune suppression.


Assuntos
Mastócitos/imunologia , Mastócitos/metabolismo , Neoplasias de Plasmócitos/etiologia , Neoplasias de Plasmócitos/metabolismo , Neovascularização Patológica/imunologia , Neovascularização Patológica/metabolismo , Animais , Biomarcadores , Medula Óssea/metabolismo , Medula Óssea/patologia , Contagem de Células , Transformação Celular Neoplásica/imunologia , Transformação Celular Neoplásica/metabolismo , Suscetibilidade a Doenças , Humanos , Mieloma Múltiplo/etiologia , Mieloma Múltiplo/metabolismo , Mieloma Múltiplo/patologia , Neoplasias de Plasmócitos/patologia , Neoplasias de Plasmócitos/terapia , Plasmocitoma/etiologia , Plasmocitoma/metabolismo , Plasmocitoma/patologia , Microambiente Tumoral
18.
Internist (Berl) ; 60(1): 42-48, 2019 01.
Artigo em Alemão | MEDLINE | ID: mdl-30560368

RESUMO

Skeletal lesions caused by multiple myeloma often lead to pain, pathological fractures, spinal instability, and compression of the spinal cord and nerve roots. The choice of therapy options is made by an interdisciplinary basis with oncologists and radiotherapists on the basis of comorbidities, prognosis, localization, and number of lesions. Surgical management has a supportive role in pain relief, the prevention and treatment of pathological fractures, and the decompression of the spinal cord and nerve roots. An adequate preoperative workup is essential for planning surgical treatment, which includes magnetic resonance imaging of the spine. In the case of unstable spinal lesions, minimally invasive and open surgical procedures, as well as their combination, are available for stabilization and decompression. In impending and pathological fractures of the extremities, surgical procedures are superior to conservative therapy for pain relief, restoring stability, walking ability, and limb function. There are multiple options available, including osteosynthesis using bone cement and plates, intramedullary nails, and bone replacement with implants and tumor endoprostheses with good functional results. Permanent reconstruction of the lesions should be the goal of any surgical intervention. The indication for curative, wide resection of the tumor should be considered for solitary plasmocytomas of the bone. Adjuvant radiotherapy leads to significantly improved local tumor control and should be considered after resection and stabilization.


Assuntos
Neoplasias Ósseas/complicações , Neoplasias Ósseas/cirurgia , Descompressão Cirúrgica/métodos , Mieloma Múltiplo/terapia , Radioterapia Adjuvante , Neoplasias da Coluna Vertebral/cirurgia , Neoplasias Ósseas/diagnóstico , Humanos , Imagem por Ressonância Magnética , Mieloma Múltiplo/diagnóstico , Metástase Neoplásica , Plasmocitoma/diagnóstico , Plasmocitoma/cirurgia , Neoplasias da Coluna Vertebral/diagnóstico por imagem
19.
Medicine (Baltimore) ; 97(50): e13374, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30557990

RESUMO

RATIONALE: We report on a patient with a positron emission tomography/computed tomography scans (PET/CT)-negative malignant spine tumor, which had even caused a pathologic fracture, and was eventually confirmed on surgical biopsy. PATIENT CONCERNS: A 67-year-old man visited our emergency department with sudden onset of lower extremities paraplegia after slip down. On examination, gradually increasing paralysis was observed in both lower limbs. DIAGNOSES: Plain radiograph and CT showed an acute burst fracture at T12 with an osteolytic mass lesion within the vertebral body and pedicle, causing severe encroachment of the spinal canal. Magnetic resonance imaging (MRI) revealed a bulging posterior cortex of the T12 vertebral body, which suspected a pathologic fracture due to malignancy. However, PET/CT showed a benign burst fracture, which was confirmed by a senior radiologist. INTERVENTION: We planned surgery for emergent decompression of the spinal cord, temporary stabilization, and tissue biopsy. The histologic evaluation confirmed the lesion to be a malignant solitary bone plasmacytoma (SBP). Seven days later, definite surgery in the form of pedicle screw fixation and posterolateral bone graft from T8 to L2 was performed. Four weeks after the definite surgery, the patient underwent radiation therapy for 2 months. OUTCOMES: Three weeks postoperatively, lower extremity motor function fully recovered, and ambulation with support was possible. One year postoperatively, spine MRI showed no evidence of local recurrence, and complete decompression of the spinal cord was achieved. LESSONS: Spine surgeons should bear in mind that malignant spine tumors could be misinterpreted as benign on PET/CT.


Assuntos
Neoplasias/diagnóstico , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Idoso , Biópsia/métodos , Diagnóstico Tardio , Diagnóstico Diferencial , Humanos , Vértebras Lombares/anormalidades , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Imagem por Ressonância Magnética/métodos , Masculino , Neoplasias/diagnóstico por imagem , Neoplasias/cirurgia , Paralisia/etiologia , Plasmocitoma/diagnóstico , Plasmocitoma/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/instrumentação , Radiografia/métodos , Fraturas da Coluna Vertebral/diagnóstico , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/cirurgia , Vértebras Torácicas/anormalidades , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/cirurgia , Tomografia Computadorizada por Raios X/métodos
20.
J Med Case Rep ; 12(1): 379, 2018 Dec 25.
Artigo em Inglês | MEDLINE | ID: mdl-30583721

RESUMO

BACKGROUND: Extramedullary plasmacytoma is an uncommon tumor that most often involves the nasopharynx or upper respiratory tract. Extramedullary plasmacytoma is a type of plasma cell neoplasm that can present as a primary tumor or secondary to another plasma cell neoplasm, such as multiple myeloma. Secondary extramedullary plasmacytoma is usually noted in the advanced stages of the disease. Involvement of the gastrointestinal tract occurs in approximately 10% of cases. CASE PRESENTATION: A 71-year-old Caucasian woman with known diverticular disease of the colon and multiple myeloma diagnosed 3 years previously, with monoclonal bands of immunoglobulin A, lambda light chains, and multiple osteolytic lesions, presented to our hospital with abdominal pain, abdominal discomfort, and pneumoperitoneum. She underwent left colectomy for diverticulitis with perforation, and an extramedullary secondary colonic plasmacytoma was found in histopathological examination of the sigmoid colon. CONCLUSIONS: Plasmacytoma is known to occur in extraosseous sites. The stomach and small intestine are the most commonly involved sites in the gastrointestinal tract. Secondary extramedullary plasmacytoma of the colon is rare. Colonic plasmacytoma may have varying clinical presentations, such as inflammatory bowel disease and multiple colonic strictures. Although these cases are rare, treating physicians as well as radiologists, pathologists, and surgeons should be aware of this entity.


Assuntos
Colo Sigmoide/patologia , Diverticulite/patologia , Mieloma Múltiplo/tratamento farmacológico , Mieloma Múltiplo/patologia , Plasmocitoma/patologia , Pneumoperitônio/patologia , Tomografia Computadorizada por Raios X , Dor Abdominal , Idoso , Colectomia , Diverticulite/cirurgia , Feminino , Humanos , Perfuração Intestinal/cirurgia , Plasmocitoma/cirurgia , Pneumoperitônio/diagnóstico por imagem , Radiografia Abdominal , Resultado do Tratamento
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