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Rare case of anaplastic plasmacytoma in the sinonasal tract
Monica H Xing1, Ariana L Shaari1, John E Beute1
1The Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York, USA.
Background:
Extramedullary plasmacytomas are tumors that develop from plasma cells and rarely express anaplastic features. To our knowledge, there have only been three reported cases of anaplastic plasmacytomas of the sinonasal tract in the English literature. We detail the fourth case.
Methods:
A 70-year-old male was seen with a 4-month history of nasal congestion, bloody mucous, and left sided nasal obstruction. On positron emission tomography/computed tomography, the lesion was FDG-avid with an SUVmax of 25.1. A biopsy of the lesion and subsequent immunohistochemical staining confirmed the diagnosis of an anaplastic plasmacytoma.
Results:
The patient is undergoing a 5-week course of curative-intent radiation therapy.
Conclusion:
Extramedullary plasmacytomas with anaplastic features are very rare. We highlight the value of thorough histopathological review and detailed immunostains to arrive at a diagnosis of anaplastic extramedullary plasmacytoma.
Insights
Anaplastic plasmacytoma of the sinonasal tract is exceptionally rare. This case report details the fourth instance, emphasizing diagnostic accuracy through histopathology and immunostains.
Area of Science:
- Oncology
- Pathology
Background:
- Extramedullary plasmacytomas (EMPs) originate from plasma cells and infrequently exhibit anaplastic characteristics.
- Anaplastic plasmacytomas of the sinonasal tract are exceedingly rare, with only three prior English literature reports.
Observation:
- A 70-year-old male presented with a 4-month history of nasal congestion, epistaxis, and unilateral nasal obstruction.
- Positron emission tomography/computed tomography revealed an FDG-avid lesion with a maximum standardized uptake value (SUVmax) of 25.1.
- Histopathological examination and immunohistochemical staining confirmed the diagnosis of an anaplastic plasmacytoma.
Findings:
- This report documents the fourth case of anaplastic plasmacytoma in the sinonasal tract.
- The patient is currently undergoing radiation therapy with curative intent.
Implications:
- This case underscores the rarity of anaplastic EMPs in the sinonasal region.
- Accurate diagnosis relies on meticulous histopathological review and comprehensive immunostaining.
- Early diagnosis and treatment are crucial for managing this rare malignancy.
