TY - JOUR
T1 - Primary plasmacytoma involving mediastinal lymph nodes
T2 - A diagnostic mimicry of primary mediastinal lymphoma
AU - Salem, Karma Z.
AU - Nishihori, Taiga
AU - Kharfan-Dabaja, Mohamed A.
AU - Horna, Pedro
AU - Alsina, Melissa
N1 - Publisher Copyright:
© 2016 King Faisal Specialist Hospital & Research Centre.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - 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.
AB - 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.
KW - Mediastinal involvement
KW - Primary plasmacytoma
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U2 - 10.1016/j.hemonc.2015.06.007
DO - 10.1016/j.hemonc.2015.06.007
M3 - Article
C2 - 26169239
AN - SCOPUS:84961164889
SN - 1658-3876
VL - 9
SP - 26
EP - 29
JO - Hematology/ Oncology and Stem Cell Therapy
JF - Hematology/ Oncology and Stem Cell Therapy
IS - 1
ER -