Treatment of solitary extramedullary plasmacytoma of the stomach with endoscopic submucosal dissection

Abstract

Extramedullary plasmacytoma (EMP) is an uncommon manifestation of plasma cell neplasia, which occurs outside the bone marrow. Intestinal involvement usually occur secondarily in multiple myeloma but it occur primarily less commonly. We experienced a woman who had a primary EMP localized in the stomach and the EMP was removed successfully by endoscopic submucosal dissection. The lesion was pathologically confirmed as confined to the gastric mucosa.

Keywords: Endoscopic submucosal dissection; Extramedullary; Plasmacytoma.

Fig. 1

Esophagogastroduodenoscopy. Well-demarcated, flat, yellow-whitish mucosal changes on the anterior and posterior walls of the lower body of the stomach.

Fig. 2

(A) The constituent tumor cells consist of mature plasma cells together with plasmablast, which have large, central, prominent nucleoli. (B) Immunohistochemistry showing positivity for lamda chains confirming monoclonal nature of tumor.

Fig. 3

Endoscopic ultrasonography finding showed extramudullary plasmacytoma of stomach confined to the mucosa.

Fig. 4

Endoscopic submucosal dissection was performed with no significant complication.

Fig. 5

(A) Low-magnification view of an endoscopic submucosal dissection specimen indicating the presence of abundant plasma cells confined to mucosa (H&E stain, ×100). (B) High-magnification view of an endoscopic submucosal dissection specimen indicating intranuclear immunoglobulin inclusion (H&E stain, ×400). (C) Immunohistochemistry showing positivity for lamda chains confirming monoclonal nature of tumor.