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Extramedullary plasmacytoma confined to the choroid
S G Honavar1, J A Shields, C L Shields
1Oncology Service, Wills Eye Hospital, Thomas Jefferson University, 900 Walnut St., Philadelphia, PA 19107, USA.
American Journal of Ophthalmology
|March 3, 2001
Summary
A rare choroidal plasmacytoma, an extramedullary plasma cell tumor, was diagnosed via fine needle aspiration biopsy. This case highlights the importance of biopsy for diagnosing rare ocular tumors.
Area of Science:
- Ophthalmology
- Oncology
- Pathology
Background:
- Extramedullary plasmacytomas (EMPs) are rare plasma cell neoplasms.
- Ocular involvement by EMPs is uncommon, with choroidal localization being particularly rare.
- Distinguishing EMPs from other amelanotic choroidal lesions is crucial for appropriate management.
Observation:
- A 76-year-old woman presented with asymptomatic, globular, orange, and amelanotic choroidal lesions in the right eye.
- Fine needle aspiration biopsy (FNAB) with immunocytochemistry confirmed monoclonal plasma cells, indicative of plasmacytoma.
- Systemic evaluation revealed elevated serum gamma globulin with an immunoglobulin kappa spike, but no evidence of multiple myeloma.
Findings:
- The diagnosis of an extramedullary plasmacytoma confined to the choroid was established.
- The patient received ocular external beam radiotherapy for localized treatment.
- At a 9-year follow-up, the patient remained disease-free and did not develop multiple myeloma.
Implications:
- This case underscores the rarity of choroidal extramedullary plasmacytoma.
- EMPs can mimic common amelanotic choroidal lesions, necessitating a high index of suspicion.
- FNAB and comprehensive systemic evaluation are critical for accurate diagnosis and management of suspected ocular plasmacytoma.
