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Hematological entities with plasmacytic differentiation: a case report.

Arati Inamdar1, Siddharth Bhattacharyya2

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This case report details a rare instance of Immunoglobulin M (IgM) extramedullary plasmacytoma in the mediastinum. Advanced diagnostic techniques like next-generation sequencing (NGS) were crucial for accurate diagnosis and treatment planning.

Keywords:
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Area of Science:

  • Oncology
  • Hematology
  • Pathology

Background:

  • Plasmacytoma is a rare plasma cell neoplasm (PCN), representing 1% of all PCNs.
  • Extramedullary plasmacytoma in the mediastinum, particularly Immunoglobulin M (IgM) type, is exceptionally rare and poses diagnostic challenges.
  • Differential diagnoses include lymphoma and other plasma cell neoplasms.

Observation:

  • A 51-year-old female presented with cough, dyspnea, and dysphagia.
  • CT imaging revealed a subcarinal mass.
  • Histopathology initially suggested lymphoma with plasma cell differentiation.

Findings:

  • Next-generation sequencing (NGS) and fluorescent in situ hybridization (FISH) confirmed IgM extramedullary plasmacytoma.
  • This diagnosis is rare and presents unique challenges.
  • Radiation therapy resulted in complete tumor regression.

Implications:

  • Accurate diagnosis of rare conditions like IgM extramedullary plasmacytoma is critical.
  • Cytogenetics and NGS play a vital role in establishing correct diagnoses.
  • Correct diagnosis impacts patient prognosis and therapeutic strategies.