[Multiple extramedullary plasmacytomas from the whole respiratory system].
Extramedullary plasmacytoma occurs most commonly in the upper respiratory tract, but rarely develops in the lung. We have recently studied an unusual case of multiple extramedullary plasmacytomas, presumably preceding localized myelomatous bone lesions. This rather unique case is, to the best of our knowledge, the first documented report of widespread multiple extramedullary plasmacytomas confined to a single organ system. A 50-year-old man was hospitalized for assessment of bilateral hilar masses on a chest radiograph. An open lung biopsy specimen was obtained, revealing plasmacytoma of the lung. Biopsy specimens from the nasal fossa also demonstrated plasma cell tumor. Moreover, a bronchoscopy revealed that the both main-stem bronchi appeared to be involved by hemorrhagic tumorous lesions. However, a biopsy could not be done because of the high risk of bleeding. Electrophoresis revealed an IgA (kappa) type M-component (2.8 g/dl) in the serum and kappa type Bence Jones proteins (0.5 g/day) in the urine. The clinical course of the present case accurately corresponds to multiple extramedullary plasmacytomas with a localized bone involvement, but not to extensive extramedullary disease associated with aggressive multiple myeloma. The occurrence of multiple extramedullary plasmacytomas confined to the respiratory system may be due to an endobronchial metastatic process or to a multicentric autochthonous process.
Kanoh
T
T
Department of Internal Medicine, Faculty of Medicine, Kyoto University.
Amitani
R
R
D001536:Bence Jones Protein / Q000652:urine; D014408:Biomarkers, Tumor / Q000032:analysis; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000473:pathology; D010954:Plasmacytoma / Q000175:diagnosis* / Q000473:pathology; D012142:Respiratory Tract Neoplasms / Q000175:diagnosis* / Q000473:pathology
D014408:Biomarkers, Tumor; D007070:Immunoglobulin A; D001536:Bence Jones Protein