The "mini brain" appearance of plasmacytoma in the appendicular skeleton.
We report on the case of a 70-year-old woman presenting with right hip pain. Radiographs of the right hip demonstrated a well-defined large lytic lesion in the proximal right femur, with prominent trabeculae situated peripherally and extending into the lesion in a "spoke-wheel" pattern. Magnetic resonance imaging (MRI) demonstrated solid enhancing marrow-replacing lesion, with intervening linear nonenhancing areas of low T2 signal intensity. The MRI appearance resembled that of a small brain or "mini brain". Biopsy specimen demonstrated predominantly mature plasma cells, with occasional admixed immature forms. A diagnosis of plasmacytosis, consistent with myeloma, was made. This case illustrates a rare but seemingly characteristic "mini brain" appearance of plasmacytoma, which, to date, has only been reported in the spine and has not been observed in other bony lesions.
Subhas
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Department of Diagnostic Radiology, Cleveland Clinic, 9500 Euclid Ave. A21, Cleveland, OH, 44195, USA. subhasn@ccf.org
Bauer
T W
TW
Joyce
M J
MJ
Sundaram
M
M
D000368:Aged; D001706:Biopsy; D005260:Female; D005266:Femoral Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D010954:Plasmacytoma / Q000175:diagnosis* / Q000473:pathology; D014057:Tomography, X-Ray Computed