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Extramedullary plasmacytoma presenting as a solitary mass in the intracranial posterior fossa.

Daghighi MH, Poureisa M, Shimia M, Mazaheri-Khamene R, Daghighi S - Iran J Radiol (2012)

Bottom Line: Intracranial SEP, although rare, should be included in the differential diagnosis of brain tumors in areas where meningiomas commonly arise.Before this case report, only few cases have been reported in the literature.Nonetheless, this is the first report of posterior fossa EMP from Iran.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Radiotherapy and Nuclear Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

ABSTRACT
A patient with a 3-month history of headache refractory to pain medication was admitted. The CT scan and MRI showed evidence of a posterior fossa mass. This was pathologically confirmed as an extra medullary plasmacytoma (EMP). He had a pathologic fracture of the left humerus 7 years ago while the radiologist was unaware at the time of diagnosis. A solitary bone plasmacytoma (SBP) was the cause of the pathologic fracture. This report includes the first description of MRI findings in a patient with a rare-incidence intracranial solitary extra medullary plasmacytoma (SEP) in Iran. There is a striking similarity between the features of intracranial SEP and meningiomas. Intracranial SEP, although rare, should be included in the differential diagnosis of brain tumors in areas where meningiomas commonly arise. The MRI findings and differential diagnosis of plasmacytoma are reviewed. Before this case report, only few cases have been reported in the literature. Nonetheless, this is the first report of posterior fossa EMP from Iran.

No MeSH data available.


Related in: MedlinePlus

Diffuse infiltration of medium-sized plasma cells with the characteristic of mild pleomorphic round oval cells, eccentric nuclei and moderate cytoplasm on H&E staining indicating a plasmacytoma.
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fig562: Diffuse infiltration of medium-sized plasma cells with the characteristic of mild pleomorphic round oval cells, eccentric nuclei and moderate cytoplasm on H&E staining indicating a plasmacytoma.

Mentions: Postoperatively, the patient was alert and showed no additional neurological deficit. Histopathological study with H&E staining demonstrated diffuse infiltration of medium-sized plasma cells with the characteristic of mild pleomorphic round oval cells, eccentric nuclei and moderate cytoplasm (Figure 2). Areas of necrosis were also present in serial sections. There was also an increased nuclear to cytoplasmic ratio and some cells had prominent nucleoli. For definite diagnosis and rule out of lymphoma, immune histochemical (IHC) staining with CD45 was considered. The infiltrating cells showed negative staining with CD45. It confirmed a diagnosis of plasma cell tumor. Bone marrow (BM) aspiration at the time of diagnosis showed no evidence of plasmacytosis. Urine studies for Bence Jones proteins, serum protein electrophoresis and urine protein electrophoresis were negative. He was discharged on a steroid regimen with a plan for radiation therapy. He had a pathological fracture of the left humerus 7 years ago. The definitive pathology report of the humeral lesion confirmed the diagnosis of solitary bone plasmacytoma (SBP), but the radiologist was unaware about this occurrence till the pathology report confirmed the nature of the mass as an SEP.


Extramedullary plasmacytoma presenting as a solitary mass in the intracranial posterior fossa.

Daghighi MH, Poureisa M, Shimia M, Mazaheri-Khamene R, Daghighi S - Iran J Radiol (2012)

Diffuse infiltration of medium-sized plasma cells with the characteristic of mild pleomorphic round oval cells, eccentric nuclei and moderate cytoplasm on H&E staining indicating a plasmacytoma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3569557&req=5

fig562: Diffuse infiltration of medium-sized plasma cells with the characteristic of mild pleomorphic round oval cells, eccentric nuclei and moderate cytoplasm on H&E staining indicating a plasmacytoma.
Mentions: Postoperatively, the patient was alert and showed no additional neurological deficit. Histopathological study with H&E staining demonstrated diffuse infiltration of medium-sized plasma cells with the characteristic of mild pleomorphic round oval cells, eccentric nuclei and moderate cytoplasm (Figure 2). Areas of necrosis were also present in serial sections. There was also an increased nuclear to cytoplasmic ratio and some cells had prominent nucleoli. For definite diagnosis and rule out of lymphoma, immune histochemical (IHC) staining with CD45 was considered. The infiltrating cells showed negative staining with CD45. It confirmed a diagnosis of plasma cell tumor. Bone marrow (BM) aspiration at the time of diagnosis showed no evidence of plasmacytosis. Urine studies for Bence Jones proteins, serum protein electrophoresis and urine protein electrophoresis were negative. He was discharged on a steroid regimen with a plan for radiation therapy. He had a pathological fracture of the left humerus 7 years ago. The definitive pathology report of the humeral lesion confirmed the diagnosis of solitary bone plasmacytoma (SBP), but the radiologist was unaware about this occurrence till the pathology report confirmed the nature of the mass as an SEP.

Bottom Line: Intracranial SEP, although rare, should be included in the differential diagnosis of brain tumors in areas where meningiomas commonly arise.Before this case report, only few cases have been reported in the literature.Nonetheless, this is the first report of posterior fossa EMP from Iran.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Radiotherapy and Nuclear Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

ABSTRACT
A patient with a 3-month history of headache refractory to pain medication was admitted. The CT scan and MRI showed evidence of a posterior fossa mass. This was pathologically confirmed as an extra medullary plasmacytoma (EMP). He had a pathologic fracture of the left humerus 7 years ago while the radiologist was unaware at the time of diagnosis. A solitary bone plasmacytoma (SBP) was the cause of the pathologic fracture. This report includes the first description of MRI findings in a patient with a rare-incidence intracranial solitary extra medullary plasmacytoma (SEP) in Iran. There is a striking similarity between the features of intracranial SEP and meningiomas. Intracranial SEP, although rare, should be included in the differential diagnosis of brain tumors in areas where meningiomas commonly arise. The MRI findings and differential diagnosis of plasmacytoma are reviewed. Before this case report, only few cases have been reported in the literature. Nonetheless, this is the first report of posterior fossa EMP from Iran.

No MeSH data available.


Related in: MedlinePlus