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Case Reports
. 2016 Sep 26:6:40.
doi: 10.4103/2156-7514.191127. eCollection 2016.

Extramedullary Plasmacytoma of the Gallbladder Detected on Fluorine 18-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

Asif Ali Fakhri  1 , Paul David Rodrigue  1 , Amena Fatima Fakhri  1
Affiliations
Case Reports

Extramedullary Plasmacytoma of the Gallbladder Detected on Fluorine 18-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

Asif Ali Fakhri et al. J Clin Imaging Sci. .

Abstract

Extramedullary plasmacytoma is rare in patients with diagnosed multiple myeloma. Soft tissue plasmacytoma of the gallbladder is particularly uncommon and has been described in only a handful of cases. Diagnosis of gallbladder plasmacytoma with fluorine 18-fluorodeoxyglucose (F18-FDG) positron emission tomography/computed tomography (PET/CT) has not previously been reported. We present a 65-year-old female with a history of multiple myeloma who underwent a restaging F18-FDG-PET/CT which showed a focal area of hypermetabolic activity, corresponding to a nodular lesion within the posterior gallbladder wall. The patient underwent successful cholecystectomy, with surgical pathology revealing gallbladder plasmacytoma. A follow-up scan was negative for active malignancy. This is a novel case of gallbladder plasmacytoma diagnosed on whole-body F18-FDG PET/CT - thus demonstrating the clinical value of this imaging modality in staging, restaging, and surveillance for patients with multiple myeloma.

Keywords: Gallbladder; fluorine 18-fluorodeoxyglucose positron emission tomography/computed tomography; plasmacytoma.

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Figures

Figure 1
Figure 1
A 65-year-old female with a history of multiple myeloma status postchemotherapy, presenting for a restaging whole-body fluorine 18-fluorodeoxyglucose positron emission tomography/computed tomography scan. (a and b) Transverse computed tomography sections of the abdomen showing nodular thickening (arrows) within the posterior gallbladder wall. (c and e) Transverse and coronal fluorine 18-fluorodeoxyglucose positron emission tomography images showing intense focal hypermetabolic activity (arrows) in the region of the gallbladder. (d and f) Fused transverse and coronal positron emission tomography/computed tomography images showing the focal area of hypermetabolic activity corresponding to the nodular thickening within the posterior gallbladder wall (arrows).
Figure 2
Figure 2
Postcholecystectomy surveillance whole-body fluorine 18-fluorodeoxyglucose positron emission tomography/computed tomography scan. (a and b) Transverse computed tomography sections of the abdomen showing postsurgical changes from cholecystectomy (arrows). (c and e) Transverse and coronal fluorine 18-fluorodeoxyglucose positron emission tomography images showing no metabolic evidence of active malignancy in the gallbladder fossa (arrows). (d and f) Fused transverse and coronal positron emission tomography/computed tomography images confirming that there is no metabolic evidence of active malignancy in the gallbladder fossa (arrows).
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