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. 2002 Nov-Dec;23(10):1632-6.

CT and MR imaging of solitary extramedullary plasmacytoma of the nasal tract

Alex Sik-Chung Ching  1 , James Boon-Kheng Khoo, Vincent Fook-Hin Chong
Affiliations

CT and MR imaging of solitary extramedullary plasmacytoma of the nasal tract

Alex Sik-Chung Ching et al. AJNR Am J Neuroradiol. 2002 Nov-Dec.

Abstract

Background and purpose: Solitary extramedullary plasmacytoma (SEP) is rare. The purpose of this study was to determine the CT and MR imaging features of SEP of the nasal tract.

Methods: We retrospectively reviewed three CT and two MR images of three histologically proved cases in two men and one woman aged 43-66 years.

Results: The plasmacytomas predominantly involved the nasopharynx in two cases and the nasal cavity in one. Two of the tumors were bulky solid masses, whereas the third showed infiltrative features. They were predominantly masses or infiltrative lesions with soft-tissue attenuation on CT scans. The lesions were isointense and hyperintense on T1- and T2-weighted MR images, respectively. The tumors revealed moderate-to-marked contrast enhancement and may have been associated with lytic bone destruction.

Conclusion: The imaging features of SEP are nonspecific. However, this entity should be included in the differential diagnosis of tumors in the nasopharynx and nasal cavity.

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Figures

F<sc>ig</sc> 1.
Fig 1.
Case 1. Images in a 43-year-old man with a 3-week history of epistaxis caused by SEP of the nasopharynx. A, Contrast-enhanced axial CT scan shows an inhomogeneous mass (asterisk) that fills the entire postnasal space, anteriorly abuts the posterior nasal septum (arrow), and posteriorly obliterates bilateral pharyngeal recesses (arrowheads). B, Nine months after local radiation therapy, this contrast-enhanced CT scan shows minimal residual disease (arrow).
F<sc>ig</sc> 2.
Fig 2.
Case 2. Images in a 66-year-old woman with nasopharyngeal extramedullary plasmacytoma who presented with a 9-month history of headache. A, Contrast-enhanced axial CT scan shows subtle asymmetry of the bilateral fossae of Rosenmuller (arrows). B, Coronal T1-weighted spin-echo MR image (TR/TE, 500/2) shows a diffuse isointense mass infiltrating the mucosal and submucosal regions (arrows). C, Axial T2-weighted fast spin-echo MR image (5400/99) shows a hyperintense lesion at the posterior pharyngeal wall (arrowhead) infiltrating the right parapharyngeal region (arrows). D, Contrast-enhanced T1-weighted spin-echo image (490/18) shows moderate-to-marked enhancement of the lesion and involvements of right medial pterygoid muscle (large black arrows), right carotid space (white arrow), clivus, and prevertebral musculature (small black arrows).
F<sc>ig</sc> 3.
Fig 3.
Case 3. Images in a 63-year-old man with a 3-month history of nasal blockage caused by nasal extramedullary plasmacytoma. A, Contrast-enhanced axial CT scan shows a large soft-tissue mass (star) filling the entire nasal cavity, with erosion of the nasal septum (curved solid arrow) and right medial maxillary wall (straight solid arrow) extending posteriorly to the nasopharynx (open arrow). B, Eight-month follow-up contrast-enhanced CT scan shows a considerable decrease in the size of the tumor (arrow) after regional radiation therapy. This finding indicates partial remission. C, Ten-month follow-up coronal T1-weighted spin-echo MR image (470/19) shows a new isointense area in the hard palate (arrows) that suggests recurrence. D, Coronal T2-weighted fast spin-echo image (5000/93) shows moderate inhomogeneous enhancement of the tumor (arrow).
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