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Primary pulmonary plasmacytoma presenting with rare IgG lambda monoclonal gammopathy
Yasmin Rahim1, Farrukh Zia Tareen2, Rashida Ahmed3
1Department of Pulmonology and Critical Care, Aga Khan University, Karachi, Pakistan.
BMJ Case Reports
|March 9, 2019
Summary
Primary pulmonary plasmacytoma (PPP), a rare lung malignancy, was diagnosed in a 55-year-old man. Treatment with chemotherapy and radiotherapy led to a favorable response, highlighting effective management strategies for this rare cancer.
Area of Science:
- Oncology
- Pulmonology
- Pathology
Background:
- Extramedullary plasmacytoma (EMP) is a malignancy outside the bone marrow.
- Primary pulmonary plasmacytoma (PPP) is a rare subset of EMP, originating in the lung.
Observation:
- A 55-year-old non-smoking male presented with chest wall swelling.
- Imaging revealed a large right upper lobe lung mass with local infiltration.
- Biopsy confirmed PPP; multiple myeloma screening was negative.
Findings:
- The patient had an IgG lambda monoclonal gammopathy, present in a minority of PPP cases.
- Treatment involved chemotherapy and radiotherapy due to disease extent.
- The patient showed a favorable response with decreased IgG levels.
Implications:
- This case highlights the importance of diagnosing and managing rare primary pulmonary plasmacytomas.
- Combined chemotherapy and radiotherapy can be effective for extensive PPP.
- Monitoring monoclonal gammopathy is crucial in PPP management.
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