Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 Feb 20:12:1433-1437.
doi: 10.2147/OTT.S190362. eCollection 2019.

Multiple extramedullary plasmacytomas of the trachea and pharyngeal tissue: a case report and literature review

Ru-Rong Tang  1 , Yan Wang  2 , Chao-Nan Liang  3 , Wei Li  3 , Ling Pei  1 , Jian Kang  3 , Gang Hou  3
Affiliations
Case Reports

Multiple extramedullary plasmacytomas of the trachea and pharyngeal tissue: a case report and literature review

Ru-Rong Tang et al. Onco Targets Ther. .

Abstract

Extramedullary plasmacytoma (EMP) is an infrequent form of plasma cell dyscrasia that presents as a mass of monoclonal plasma cells located in extramedullary soft tissues with no skeletal component. EMP constitutes ~4% of all plasma cell neoplasms and occurs mostly in the upper respiratory tract. Here, we report a rare case of multiple EMPs involving the trachea, laryngopharynx, and oropharynx, which caused symptoms of airway obstruction as the only clinical manifestation. The patient was diagnosed by histopathology of the tissue from bronchoscopic resection and successfully managed with bronchoscopic intervention to treat lesions in the trachea and radiotherapy combined with surgical resection to treat lesions in the pharynx. There was no recurrence after 14 months of follow-up. Endoscopic intervention plays a key role in the rapid diagnosis and treatment of EMP involving the central airways.

Keywords: bronchoscopy; cryotherapy; interventional pulmonology; plasmacytoma; tracheal tumors.

PubMed Disclaimer

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The manifestations of chest CT. Notes: (A) Chest CT on admission showed a soft tissue mass in the trachea. (B) Chest CT after radiotherapy showed that the lesion disappeared completely. Abbreviation: CT, computed tomography.
Figure 2
Figure 2
The bronchoscopic manifestations of the lesion. Notes: (A) Bronchoscopy revealed two nodular masses with pedicles arising from the posterior wall of the trachea, occluding ~95% of the tracheal lumen. (B) At the end of 14-month follow-up, repeated bronchoscopy revealed complete recovery of the lesion.
Figure 3
Figure 3
The size of the excised tumor. Notes: (A) The long axis was 2.3 cm. (B) The short axis was 1.5 cm.
Figure 4
Figure 4
Histopathology of the tumor. Notes: (A) The plasma cells are relatively uniform and most have eccentrically located nuclei (H&E, 400×). (B) The nuclear chromatin is dispersed, and a prominent centrally located nucleolus can be found in each nucleus (H&E, 400×). Immunohistochemical staining showed (C) expression of CD38, (D) absence of CD20, (E) cytoplasmic lambda light chain positivity, and (F) absence of kappa light chain expression. (G) The MIB-1 (Ki67) index is ~10%.
Figure 5
Figure 5
The manifestation of 18FDG-PET/CT. Note: 18FDG-PET/CT showed localized and increased FDG uptake within the anterior and posterior walls of the laryngopharynx. Abbreviation: 18FDG-PET/CT, 18-fluorodeoxyglucose positron emission tomography.
Figure 6
Figure 6
The laryngoscopic manifestations of the tumor. Notes: (A) Laryngoscopy showed multiple nodules located in the laryngopharynx. (B) Laryngoscopy after radiotherapy showed two adjacent smooth neoplasms on the back of the soft palate.
Figure 7
Figure 7
Enhanced MRI of laryngopharynx. Notes: (A) MRI of the nasopharynx showed a round tumor located in the mucosa of the left oropharynx, ~7 mm in diameter, that had homogeneous signal intensity similar to the signal intensity of the mucosa on T1-weighted imaging and was enhanced with contrast. (B) On T2-weighted imaging, the signal intensity of the tumor was moderately higher than that of the mucosa.
See this image and copyright information in PMC

References

    1. Soutar R, Lucraft H, Jackson G, et al. Guidelines on the diagnosis and management of solitary plasmacytoma of bone and solitary extramedullary plasmacytoma. Br J Haematol. 2004;124(6):717–726. - PubMed
    1. Alexiou C, Kau RJ, Dietzfelbinger H, et al. Extramedullary plasmacytoma: tumor occurrence and therapeutic concepts. Cancer. 1999;85(11):2305–2314. - PubMed
    1. Sukumaran R, Nair RA, Jacob PM, Koshy SM, Mathew AP. Extra-medullary plasmacytoma of the trachea. Head Neck Pathol. 2014;8(2):220–224. - PMC - PubMed
    1. Stevic R, Ercegovac M, Stojšić J, Čolić N. Rare tracheal tumor: solitary plasmacytoma. J Postgrad Med. 2018;64(2):115–118. - PMC - PubMed
    1. Rai SP, Kumar R, Bharadwaj R, Panda BN. Plasmacytoma stracheal solitary tracheal plasmacytoma. Indian J Chest Dis Allied Sci. 2003;45(4):269–272. - PubMed

Publication types