IgM-producing renal plasmacytoma

Renal Riddles Unveiled: Decoding Homogeneous Kidney Enlargement in Multiple Myeloma

Renal plasmacytoma is a rare extramedullary manifestation of plasma cell neoplasms (PCN). We present the case of a 62-year-old male with a history of relapsed refractory multiple myeloma (MM) who developed secondary renal plasmacytoma after an eight-year remission period. Radiological findings on plain CT raised concern for the most common renal malignancy, i.e. renal cell carcinoma (RCC), while further imagining evaluation with MRI suggested renal lymphoma, highlighting the diagnostic challenge of renal plasmacytoma on imagining. A renal mass biopsy confirmed a kappa-restricted plasma cell tumor, emphasizing the need for accurate differentiation between renal plasmacytoma and other renal malignancies to guide appropriate treatment strategies. Increased awareness of such cases can lead to timely recognition and tailored management for this rare entity.

Hematological entities with plasmacytic differentiation: a case report

INTRODUCTION

Plasmacytoma, a localized tumor of monoclonal plasma cells without any clinical, radiological or physical evidence of plasma cell neoplasm (PCN), is a rare entity that accounts for 1% of PCN. Immunoglobulin M (IgM) extramedullary plasmacytoma of mediastinal region has never been reported and is a diagnostic challenge considering other differential diagnoses.

CASE PRESENTATION

We present the case of a 51-year-old African-American female with progressively increasing cough, dyspnea, and dysphagia for 6 months with a computed tomography (CT) scan revealing a subcarinal mass. The histopathological analysis of the mass reveals a diagnosis of lymphoma with plasma cell differentiation, with a differential of lymphoplasmacytic lymphoma and plasma cell neoplasm. The lymphoma panel via next-generation sequencing (NGS) and a myeloma-targeted fluorescent in situ hybridization (FISH) panel confirmed the diagnosis of IgM extramedullary plasmacytoma, an entity of rare occurrence. Treatment with radiation led to complete regression of the plasmacytoma with normal blood work-up.

CONCLUSIONS

This report describes the challenges of diagnosing IgM extramedullary plasmactyoma. Our case report highlights the importance of cytogenetics and NGS in establishing a correct diagnosis that indeed has prognostic and therapeutic implications.

Refractory primary extramedullary plasmacytoma in kidney: a case report

Extramedullary plasmacytoma (EMP) is a rare plasma cell neoplasm, with the majority (80–90% of cases) occurring in the upper aerodigestive tract. To our best knowledge, primary EMP from renal tissues is extremely rare. Herein, the diagnosis and treatment of a refractory primary EMP with renal involvement in a 53-year-old male patient is reported. The patient received radical nephrectomy followed by radiotherapy, and showed relapse 3 months after treatment. The cancer cells were sensitive to subsequent chemotherapy, however, the patient died of infection associated with the disease after almost 3.5 years following first presentation.

Renal plasmacytoma: Report of a rare case and review of the literature

Renal plasmacytoma is extremely rare, presenting diagnostic challenges due to its unusual location and non-specific or absent symptoms. To the best of our knowledge, only 24 cases of renal plasmacytoma have been reported in the literature. The present study reports a case of primary renal plasmacytoma in a 46-year-old female patient. Computed tomography (CT) revealed that the mass was located in the lower pole of the left kidney and metastasis was detected in an enlarged para-aortic lymph node. Following careful preparation, a partial nephrectomy was performed and the retroperitoneal lymph node was resected. A pathological examination revealed a renal parenchyma with lymph node involvement; this was confirmed by immunohistochemistry and nested polymerase chain reaction (PCR). Consequently, a diagnosis of a renal extramedullary plasmacytoma (EMP) was proposed. Following this unexpected diagnosis, various examinations were performed, but there was no evidence of systemic plasma cell disease. The patient refused further therapy, including external beam radiotherapy and chemotherapy. Abdominal CT was performed three months post-surgery and did not reveal any relapse. The patient remains disease-free at nine months post-surgery. The current study also presents a review of the literature. Although the general prognosis and outcome of EMP is good, a follow-up examination is recommended due to the possibility of relapse or progression to plasma cell neoplasm (PCN).

Ga-67 and Tl-201 scintigraphy in extramedullary plasmacytoma: a case report

Extramedullary plasmacytoma is a rare form of plasma cell tumor occurring in a wide variety of organs and tissues. Most tumors occur in the head and neck, involving the nasal cavity, paranasal sinuses, and upper airway. Tl-201 and Ga-67 scan findings in a patient with extramedullary plasmacytoma in the right side of the chest wall are presented. Only a few publications have described Tl-201 or Ga-67 uptake in extramedullary plasmacytoma. This is the first report of both Tl-201 and Ga-67 uptake in an extramedullary (or intramedullary) plasmacytoma.