Plasmocitoma extramedular. Una rara causa de masa mediastínica

Solitary extramedullary plasmacytomas represent 3% of plasma cell neoplasms. Their most common locations are the upper gastrointestinal and respiratory tract. We report a 70-year-old male presenting with progressive dyspnea and cough. A chest radiography showed widened mediastinum. Chest computed to...

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Autores principales:	Quilodrán,Javier A., Peña,Camila, Valladares,Ximena
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2017
Materias:	Mediastinal neoplasms Plasma cells Plasmacytoma
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000600812
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spelling	oai:scielo:S0034-988720170006008122017-11-17Plasmocitoma extramedular. Una rara causa de masa mediastínicaQuilodrán,Javier A.Peña,CamilaValladares,Ximena Mediastinal neoplasms Plasma cells Plasmacytoma Solitary extramedullary plasmacytomas represent 3% of plasma cell neoplasms. Their most common locations are the upper gastrointestinal and respiratory tract. We report a 70-year-old male presenting with progressive dyspnea and cough. A chest radiography showed widened mediastinum. Chest computed tomography showed a mediastinal mass. A bronchoscopy showed an extrinsic compression and complete occlusion of the primary bronchus. A self-expandable prosthesis was installed in left bronchus. A population of plasmacytoid cells was evidenced in the mass biopsy. Immunohistochemistry revealed CD20+ and CD138+. These tumor cells stained positively for lambda light chains, but negatively for kappa chains. Therefore an extramedullary plasmacytoma was diagnosed. A multiple myeloma was discarded with a normal blood count, serum calcium and creatinine levels. Serum protein electrophoresis had a monoclonal spike, serum IgG was 1963 mg/dl. Bone marrow aspiration had 1% of plasma cells. Bone x-rays were normal. Computed tomographies of the neck, thorax, abdomen and pelvis ruled out other plasmacytomas. Eight cycles of chemotherapy with thalidomide, melphalan and prednisone were indicated, obtaining complete remission of the tumor. The review of the literature shows that mediastinal extramedullary plasmacytomas are extremely rare. They generally appear in men aged between 50 and 60 years. The treatment of choice is radiotherapy, but given the location in the present case, chemotherapy was considered the best option. Recurrence is approximately 10 to 30% and 10% of patients progress to myeloma, thus requiring close monitoring.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.145 n.6 20172017-06-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000600812es10.4067/s0034-98872017000600812
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Mediastinal neoplasms Plasma cells Plasmacytoma
spellingShingle	Mediastinal neoplasms Plasma cells Plasmacytoma Quilodrán,Javier A. Peña,Camila Valladares,Ximena Plasmocitoma extramedular. Una rara causa de masa mediastínica
description	Solitary extramedullary plasmacytomas represent 3% of plasma cell neoplasms. Their most common locations are the upper gastrointestinal and respiratory tract. We report a 70-year-old male presenting with progressive dyspnea and cough. A chest radiography showed widened mediastinum. Chest computed tomography showed a mediastinal mass. A bronchoscopy showed an extrinsic compression and complete occlusion of the primary bronchus. A self-expandable prosthesis was installed in left bronchus. A population of plasmacytoid cells was evidenced in the mass biopsy. Immunohistochemistry revealed CD20+ and CD138+. These tumor cells stained positively for lambda light chains, but negatively for kappa chains. Therefore an extramedullary plasmacytoma was diagnosed. A multiple myeloma was discarded with a normal blood count, serum calcium and creatinine levels. Serum protein electrophoresis had a monoclonal spike, serum IgG was 1963 mg/dl. Bone marrow aspiration had 1% of plasma cells. Bone x-rays were normal. Computed tomographies of the neck, thorax, abdomen and pelvis ruled out other plasmacytomas. Eight cycles of chemotherapy with thalidomide, melphalan and prednisone were indicated, obtaining complete remission of the tumor. The review of the literature shows that mediastinal extramedullary plasmacytomas are extremely rare. They generally appear in men aged between 50 and 60 years. The treatment of choice is radiotherapy, but given the location in the present case, chemotherapy was considered the best option. Recurrence is approximately 10 to 30% and 10% of patients progress to myeloma, thus requiring close monitoring.
author	Quilodrán,Javier A. Peña,Camila Valladares,Ximena
author_facet	Quilodrán,Javier A. Peña,Camila Valladares,Ximena
author_sort	Quilodrán,Javier A.
title	Plasmocitoma extramedular. Una rara causa de masa mediastínica
title_short	Plasmocitoma extramedular. Una rara causa de masa mediastínica
title_full	Plasmocitoma extramedular. Una rara causa de masa mediastínica
title_fullStr	Plasmocitoma extramedular. Una rara causa de masa mediastínica
title_full_unstemmed	Plasmocitoma extramedular. Una rara causa de masa mediastínica
title_sort	plasmocitoma extramedular. una rara causa de masa mediastínica
publisher	Sociedad Médica de Santiago
publishDate	2017
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000600812
work_keys_str_mv	AT quilodranjaviera plasmocitomaextramedularunararacausademasamediastinica AT penacamila plasmocitomaextramedularunararacausademasamediastinica AT valladaresximena plasmocitomaextramedularunararacausademasamediastinica
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Plasmocitoma extramedular. Una rara causa de masa mediastínica

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