Extramedullary plasmacytoma of the parotid gland: report of a case and review of the literature

Primary extraosseous plasmacytoma of the parotid gland: A case report and literature review

Extraosseous plasmacytoma (EOP) is an uncommon malignant tumour that is characterised by the monoclonal proliferation of abnormal plasma cells in soft tissue; however, EOP lacks the defining features of multiple myeloma or medullary plasmacytoma. Although the majority of EOP lesions occur in the head and neck, EOP of the parotid gland is extremely uncommon. The present study aimed to explore the clinical features of parotid plasmacytoma, in addition to the diagnostic and therapeutic options for its management. Using the Medline database, a search was conducted for articles published on the topic of ‘parotid plasmacytoma’ up until the year 2016. A total of 20 cases were evaluated, including 19 clinical cases from the literature and 1 new clinical case from our hospital. Among the 19 previously published cases, the mean age at the time of diagnosis of EOP was 65.1±10.9 years (range, 38–78 years). Plasmacytomas were located unilaterally in all cases: On the right side in 9 patients (47.4%), on the left side in 10 patients (52.6%). Treatment included chemotherapy in 3 cases, radiotherapy in 11 cases and surgical removal in 15 cases. The diagnosis of EOP is based on the presence of a localised tumour comprising monoclonal plasma cells, and EOP is identical to multiple myeloma in this regard; however, EOP, in contrast to multiple myeloma, does not exhibit the signs that are indicative of disseminated disease, such as additional lesions on skeletal radiological examination, plasmacytosis in the bone marrow, and hypercalcaemia, anaemia, or renal failure. Thus, EOP must be considered in the differential diagnosis of parotid gland lesions in order to avoid confusion with other tumoural diseases.

Solitary Plasmacytoma of the Parotid Gland with Crystalline Inclusions: A Case Report

BACKGROUND: Solitary extramedullary plasmacytoma of the parotid gland is a rare condition. Intracytoplasmic Crystalline inclusions in the tumor are even rarer and have been reported only once in the parotid gland. CASE PRESENTATION: We report here, a case of plasmacytoma of the parotid gland with intracellular crystalline inclusions in a 73-year-old woman CONCLUSION: Solitary extramedullary plasmacytoma of the parotid gland and crystalline inclusions in the tumor is of rare occurrence. The importance of such a finding with relation to tumor progression, clinical course of the disease or prognosis in general remains to be understood.

Primary extramedullary plasmacytoma of the parotid gland: a case report and review of the literature

Solitary extramedullary plasmacytomas are uncommon malignant neoplasms with a great predilection for the upper respiratory tract. Extramedullary plasmacytoma involving the parotid gland is an extremely rare condition. This report describes the case of a primary extramedullary plasmacytoma arising in the right parotid gland of a 63-year-old man. A review of the literature reveals that this disease has generally a good prognosis. provided that multiple myeloma has been excluded. The treatment of choice should be surgical excision followed by radiotherapy, although from this study there is insufficient evidence to suggest that this is more effective than surgery alone. All patients must have regular long-term follow-up to monitor for recurrence or dissemination, in which event chemotherapy may be considered in addition to the other treatment modalities.

Extramedullary plasmacytoma of the thyroid, associated with follicular colonization and stromal deposition of polytypic immunoglobulins and major histocompatibility antigens. Possible categorization in MALT lymphoma

A 78-year-old woman complaining of a neck mass underwent right hemithyroidectomy. The 7 x 6 cm thyroid tumor consisted predominantly of mildly atypical, epithelial membrane antigen-positive plasma cells and scattered lymphoid follicles. Features of follicular colonization (plasma cell infiltration into germinal centers) were noted. Numerous CD45RO-positive reactive T cells and a smaller number of CD20-positive blast-like B cells were also distributed among the plasma cell infiltrate. IgG, kappa-type monoclonality with J-chain reactivity was identified in the plasma cells, including those in the lymphoid follicles. The association of pre-existing lymphocytic thyroiditis was confirmed histologically in the non-tumorous thyroid tissue. The tumor exhibited deposition of reticulin fiber-rich, amorphous eosinophilic substances, provoking pronounced foreign body reactions. The deposit, polytypically immunoreactive for immunoglobulin gamma-, mu-, kappa- and lambda-chains, beta 2-microglobulin and HLA-DR, was scarcely reactive upon amyloid staining, and consisted ultrastructurally of electron-dense, non-fibrillar material and entrapped collagen fibers. Multiple myeloma was ruled out by laboratory, histologic and clinical examinations. The possible categorization of this extramedullary plasmacytoma of the thyroid within low-grade B cell lymphoma of the mucosa-associated lymphoid tissue (MALT) is discussed.

Primary extramedullary plasmacytoma of the salivary glands

Primary extramedullary plasmacytomas (PEMP) are uncommon plasma cell neoplasms that generally occur in the submucosal tissue of the upper airway. Salivary gland PEMP is an extremely rare condition. This report describes a unique case of PEMP in the parotid gland associated with pulmonary amyloidosis. A review of all salivary gland PEMP's suggests that they behave similarly to PEMP's in other locations. The treatment of choice for localized disease is radiotherapy which should include regional lymphatics. Local control can be achieved in the majority of cases. The minority of patients develop systemic metastases and die from their disease. Chemotherapy can control disseminated disease and may induce remission.

Parotid gland plasmacytoma with crystalline deposits

A case of primary extramedullary plasmacytoma of the parotid gland with a marked deposition of intracytoplasmic crystals is presented. The immunohistochemical and ultrastructural characteristics of the crystals suggest formation from monoclonal immunoglobulin.

Extramedullary plasmacytoma of the parotid

Primary extramedullary plasmacytoma (PEMP) is a tumor of atypical neoplastic cells that arise outside the bone marrow in patients without clinical evidence of existing multiple myeloma. These rare tumors, which can occur in virtually any part of the body, have shown a clear predilection for the head and neck. Yet despite the fact that nearly 80% of these tumors can be found in the upper respiratory tract or oral cavity, their involvement in the parotid is singularly rare. The clinical behavior of this tumor is not yet well-defined, and local recurrence, distant metastasis, and transformation to multiple myeloma have all been reported. Since the first case of parotid PEMP was reported in 1965, 8 additional cases have been noted in the literature. This is the 9th case of PEMP of the parotid to be described.

Plasma cell dyscrasias: current status

This is a review of the current status of the monoclonal gammopathies (plasma cell dyscrasias). We begin with the recognition of a monoclonal protein in serum and urine. We briefly discuss the differential diagnosis of the monoclonal gammopathies. Clinical and laboratory findings as well as the management of multiple myeloma are addressed. Future approaches for the treatment of myeloma are provided. The variant forms of multiple myeloma, including smoldering myeloma, plasma cell leukemia, nonsecretory myeloma, IgD myeloma, osteosclerotic myeloma, solitary plasmacytoma of bone, and extramedullary plasmacytoma, are briefly reviewed. Diagnosis and treatment of Waldenström's macroglobulinemia are presented. The recognition and differential diagnosis of the heavy-chain diseases (gamma, alpha, and mu) are included. Monoclonal gammopathy of undetermined significance ("benign" monoclonal gammopathy) is presented in detail. Amyloidosis is not included in this review.