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[Diffuse gingival plasmocytoma: a rare location of extra-osseous solitary plasmocytomas (author's transl)].

A 51-year-old man presented with isolated diffuse gingival hypertrophy, the diagnosis of a plasmocytoma being suspected after pathological and immunohistological examinations of a gingival biopsy (light chain lambda plasmocytes). The isolated nature of this diffuse gingival plasmocytoma was confirmed by biological tests and radiological investigations. The evolution of solitary plasmocytomas is variable, and while certain of these lesions remain isolated even after many years, other plasmocytomas, apparently local, are associated with myelomas which either become evident or may sometimes develop. The extremely rare nature of diffuse gingival locations of extra-osseous solitary plasmocytomas is confirmed by a review of the published literature. Studying histological sections by immunofluorescence enables the polyclonal or monoclonal nature of the plasmocytes to be established, this distinction being an important element in the prognosis.

Fluorescent Antibody Technique↗

[Intracranial plasmocytomas: biology, diagnosis, and treatment].

Intracranial plasmocytomas are a rare abnormality in a neurosurgeon's practice. The plasmocytomas may originate from the skull bones or soft tissue intracranial structures; they may be solitary or occur as a manifestation of multiple myeloma, this type being typical of most intracranial plasmocytomas. Progression of solitary plasmocytoma to multiple myeloma is observed in a number of cases. Preoperative diagnosis involves computed tomography or magnetic resonance imaging; angiography is desirable. The final diagnosis of plasmocytoma is chiefly based on a morphological study. Special immunohistochemical studies yield very promising results; these are likely to be of high prognostic value. Intracranial plasmocytomas require a differential approach and a meticulous examination since the presence or absence of multiple myeloma radically affects prognosis. There are well-defined predictors; however, it is appropriate that craniobasal plasmocytomas show a worse prognosis than plasmocytomas of the skull vault and more commonly progress to multiple myeloma. Plasmocytomas respond to radiotherapy very well. The gold standard of treatment for plasmocytoma is its total removal and adjuvant radiation therapy; however, there is evidence for good results when it is partially removed and undergoes radiotherapy or after radical surgery without subsequent radiation. The role of chemotherapy has not been defined today.

Humans↗

Upper airways locations of plasmocytoma.

We report one case of extramedullary plasmocytoma located in the nasopharynx. After 8 years, the tumor recurred in the same location and 3 years later, the patient develop a multiple myeloma. Three clinical and pathological entities of plasmocytoma are described: multiple myeloma, solitary bone plasmocytoma and extramedullary plasmocytoma. When histological examination show plasmocytoma, further examinations can or not reveal a multiple myeloma. In 80% of cases, extramedullary plasmocytoma occur in the upper respiratory tract. This development of multiple myeloma from extramedullary plasmocytoma is seen in 5 to 32% of patients and sometimes an extremely long time is required for the change to occur. The treatments are surgery and radiation in the absence of generalized disease.

Aged↗

Mandibular involvement of solitary plasmocytoma: a case report.

Plasma cell neoplasms (multiple myeloma, solitary plasmocytoma of bone and extra medullar plasmocytoma) are characterized by a monoclonal neoplastic proliferation of plasma cells. Solitary plasmocytoma of bone (SPB) is a localized form of them. SPB is most frequently seen in vertebrae and secondarily in long bones. Its presence in jaws is extremely rare and when it is seen, angulus and ramus mandible are most common sites of occurrence. Prognosis of SPB is worse than extra medullar plasmacytoma (EMP) and approximately 50% of SPB will transform to multiple myelom. A 76-year old woman consulted to our clinic with a chief complaint of slowly developed swelling in her mandible. She had an operation from caput femur because of plasmocytoma two months before. Panoramic radiography revealed a radiolucent lesion in the mandibular anterior region, 60x35 mm in dimension. Aspiration biopsy was performed and histopathological examination was reported as plasmocytoma. She was referred to the oncology department for treatment but died before the treatment finished.

Aged↗

[Solitary plasmocytoma of the rib: a rare tumor not to miss].

Solitary plasmocytoma is a rare tumor accounting for 5% of all plasma cell neoplasias. The diagnosis is based on identification of the localized tumor composed of monoclonal plasma cells identical to those observed in multiple myeloma, and absence of the signs in favor of a disseminated form. We report the case of a52-year-old man who presented a growth of the chest wall in the left axillary region. Imaging disclosed a mass of tissue with a large zone of osteolysis of the 6th rib and infiltration of the chest wall. Surgical biopsy for pathology study and immunohistochemistry enabled the diagnosis of costal plasmocytoma. Blood protein immunoelectrophoresis revealed a monoclonal kappa type IgG. Bence-Jones proteinuria was positive. Search for other localizations was negative and the diagnosis of solitary plasmocytoma was retained. Radiotherapy was delivered and the patient has remained in remission at one year. Costal localization is rare for solitary plasmocytoma. The diagnosis is based on imaging findings and pathology. Radiotherapy is the treatment of choice but with the risk of progression with other bone lesions, the development of medullary plasmocytosis and multiple myeloma. Factors predictive of systemic recurrence have not been identified. Regular surveillance is required.

Bone Neoplasms↗

[Endonasal plasmocytoma: diagnosis and management].

UNLABELLED: Plasmocytomas are either medullary (disseminated form) or extramedullary with or without bone infiltration (located form). Plasmocytoma is not a common tumor but extramedullary forms mostly occur in the upper respiratory tract without specific manifestations. OBJECTIVE: The aim of this study is to discuss the management (diagnostic and therapeutic) and the follow-up of extramedullary nasal plasmocytoma. MATERIAL AND METHODS: We report a case of a 71-year-old patient with unilateral nasal obstruction manifestation. RESULTS: Endonasal biopsy concluded plasma cell tumor without extension on CT scan. Treatment consisted of external nasal surgery and radiotherapy. CONCLUSION: Diagnosis of solitary extramedullary plasmocytoma can only be confirmed when the presence of systemic disease is excluded by performing clinical, biological (marrow bone biopsy) and radiological investigations. The treatment should be based on surgery with complementary radiotherapy if there is a skull base erosion. Long term follow-up is necessary because of the high risk of diffuse marrow involvement (multiple myeloma) which may occur after a long delay.

Aged↗

Plasmocytoma (a study of 222 cases).

In a review of 222 cases of plasmocytoma, the author demonstrates that solitary plasmocytoma is not rare and has a different localization in bone as compared with the multiple type. The prognosis is influenced by the number of lesions, the level of the anemia, calcemia and hypoalbuminaemia, and the type and level of the paraproteins. In solitary plasmocytoma, the prognosis is also conditioned by the sex of the patient and the site of the primary localization. Proteinaemia was increased in only 40 per cent of cases and electrophoresis was negative in 20 per cent. The treatment of choice for plasmocytoma is radiotherapy associated with Malphalan.

Adult↗

[Differential diagnosis and therapy of plasmocytoma of the head and neck (author's transl)].

The differential diagnosis, therapy, and prognosis of extramedullary plasmocytoma of the mucosa in the head and neck region are discussed on the example of 10 own cases observed between 1965 and 1981. They are subdivided into three types: 1. The apparent solitary (or multiple) extramedullary plasmocytoma. However, after thorough clinical and paraclinical examination or after observation of the course of the disease the exact diagnosis of medullary plasmocytoma is established. For the therapy, cytostatics must be employed, and prognosis is unfavourable. 2. The genuine plasmocytoma of the mucosa. It has to be distinguished from the immunocytic lymphoma and corresponds to a Non-Hodgkin's-Lymphoma. The therapy is partly surgical and partly radiological; as a rule, prognosis is good. 3. The tumour-like granuloma of plasma cells which is of reactive inflammatory nature. Treatment is surgical only.

Adult↗