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 Scopus citations

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

Keywords

  • Mediastinal involvement
  • Primary plasmacytoma

ASJC Scopus subject areas

  • Hematology
  • Oncology

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