Primary plasmacytoma involving mediastinal lymph nodes: A diagnostic mimicry of primary mediastinal lymphoma

Karma Z. Salem, Taiga Nishihori, Mohamed A. Kharfan-Dabaja, Pedro Horna, Melissa Alsina

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Plasmacytomas could involve any organ, and at times might pose a diagnostic challenge when the site of involvement is unusual, or if the presentation is similar to other diseases. We describe a 48-year-old man presenting with worsening shortness of breath and chest discomfort with radiologic evidence of mediastinal enlargement, mimicking a lymphoma with mediastinal involvement. An excisional biopsy of a mediastinal lymph node showed a plasma-cell infiltrate strongly positive for CD138, with a flow-cytometry analysis showing a population of lambda-restricted neoplastic plasma cells. He failed to respond to 50 Gy involved-field radiotherapy, but achieved a partial response to combination chemotherapy. He underwent high-dose chemotherapy with melphalan (200 mg/m2) followed by lenalidomide maintenance, and is in complete remission 18 months postautografting. This case illustrates a unique and rare presentation of primary lymph-node plasmacytomas involving the mediastinum potentially mistaken as lymphoid malignancy. Clinicians should be aware of the plasma-cell origin of the mediastinal neoplastic process.

Original languageEnglish (US)
Pages (from-to)26-29
Number of pages4
JournalHematology/ Oncology and Stem Cell Therapy
Volume9
Issue number1
DOIs
StatePublished - Mar 1 2016
Externally publishedYes

Fingerprint

Plasmacytoma
Plasma Cells
Lymphoma
Lymph Nodes
Neoplastic Processes
Melphalan
Mediastinum
Combination Drug Therapy
Dyspnea
Flow Cytometry
Radiotherapy
Thorax
Maintenance
Biopsy
Drug Therapy
Population
Neoplasms

Keywords

  • Mediastinal involvement
  • Primary plasmacytoma

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

Primary plasmacytoma involving mediastinal lymph nodes : A diagnostic mimicry of primary mediastinal lymphoma. / Salem, Karma Z.; Nishihori, Taiga; Kharfan-Dabaja, Mohamed A.; Horna, Pedro; Alsina, Melissa.

In: Hematology/ Oncology and Stem Cell Therapy, Vol. 9, No. 1, 01.03.2016, p. 26-29.

Research output: Contribution to journalArticle

Salem, Karma Z. ; Nishihori, Taiga ; Kharfan-Dabaja, Mohamed A. ; Horna, Pedro ; Alsina, Melissa. / Primary plasmacytoma involving mediastinal lymph nodes : A diagnostic mimicry of primary mediastinal lymphoma. In: Hematology/ Oncology and Stem Cell Therapy. 2016 ; Vol. 9, No. 1. pp. 26-29.
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