Fine needle aspiration biopsy of extramedullary plasma cell tumors

Fourteen fine needle aspiration (FNA) biopsies of extramedullary plasma cell tumors (PCT) from 11 patients were reviewed and correlated with histology in eight patients. This series comprised seven men and four women ranging in age from 46 to 83 yr (median 69 yr). Discrete masses were located in lymph nodes (three patients), pleura (one patient), soft tissues of the neck (two patients), thorax (six patients), axilla (one patient), and inguinal region (one patient). A spectrum of cytologic findings was demonstrated which led to the clinical confirmation of myeloma in four of 11 patients and of solitary plasmacytoma in two of 11 patients. In addition, FNA biopsies confirmed the presence of extramedullary disease in four of 11 patients with previously diagnosed myeloma. In another patient with a poorly differentiated plasma cell neoplasm, excisional biopsy was recommended to confirm the presence of a plasma cell tumor. Clinical follow-up was available on ten patients; of these, nine were treated with aggressive chemotherapy and, in five instances, additional radiotherapy. The 10th patient succumbed to infection prior to treatment. Nine of the ten patients were dead of disease 3 days to 4 yr following clinical diagnosis of a plasma cell dyscrasia. One patient (Case 1) was lost to follow-up after biopsy confirmation of plasmacytoma. The cytomorphologic appearance of neoplastic plasma cells in FNA of solitary masses necessitates clinical evaluation for bone marrow disease, i.e., myeloma.(ABSTRACT TRUNCATED AT 250 WORDS)