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Multiple plasmacytomas with thoracic and biliary involvement.

T L Simon, I K Rughani, D J Pierson

Archives of Internal Medicine

|July 1, 1978

Summary

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This case study highlights rare extraosseous plasmacytomas in nonsecretory multiple myeloma, presenting as pleural, subcutaneous, pancreatic, and pulmonary lesions. Early diagnosis and treatment led to a positive patient outcome.

Area of Science:

Oncology
Hematology

Background:

Nonsecretory multiple myeloma (NSMM) is a rare subtype of multiple myeloma.
Extraosseous involvement in multiple myeloma can present unique diagnostic and therapeutic challenges.

Observation:

A patient with NSMM developed extraosseous plasmacytomas involving pleural effusion, subcutaneous masses, and pancreatic head mass causing obstructive jaundice.
Bilateral pulmonary nodules and endobronchial lesions were identified via fiberoptic bronchoscopy.

Findings:

Histologic examination of endobronchial lesions confirmed plasmacytoma, consistent with the patient's original osseous lesions.
The pancreatic mass responded to radiation therapy, and pulmonary nodules improved with cyclophosphamide and prednisone treatment.
The patient exhibited three forms of intrathoracic myeloma: rib lesions, pleural disease, and endobronchial masses.

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Implications:

This case underscores the rare occurrence of biliary and pulmonary plasmacytoma manifestations.
Noninvasive diagnostic methods and prompt response to conservative therapy were crucial for managing this complex presentation.
Highlights the diverse clinical presentations of extraosseous plasmacytomas in NSMM.