title: Pancreatic involvement by plasma cell neoplasms.
abstract: BACKGROUND
  Pancreatic involvement by plasma cell neoplasms is an extremely rare event, with only 50 cases described in the literature. They can present as a primary solitary extramedullary plasmacytoma or plasmacytoma secondary to a plasma cell myeloma. Clinical manifestations are due to the presence of a pancreatic mass usually in the pancreas head, which causes extra-biliary obstruction and abdominal pain.
  
  
  METHODS
  Abdominal imaging including CT scan or endoscopic ultrasound with fine-needle aspiration tissue sampling is essential for the initial diagnostic procedure. However, immunohistochemical analysis of the biopsy specimen or flow cytometry of the aspirated material is crucial to prove the monoclonality and the final diagnosis of a plasma cell neoplasm.
  
  
  CONCLUSIONS
  Management of these situations include radiotherapy, chemotherapy, surgery or combined therapy. Novel medications including the immunomodulatory drugs or the proteasome inhibitors followed by consolidation with intensive chemotherapy and haematopoietic stem cell transplantation are nowadays used as upfront treatment in the cases associated to a plasma cell myeloma.
  
  
  CONCLUSIONS
  Despite the rarity, plasma cell neoplasms should be considered in the differential diagnosis of obstructive jaundice and pancreatic neoplasms since they are potentially treatable situations.
authors.affiliation: Hospital Santo António dos Capuchos-CHLC, Alameda Santo António dos Capuchos, 1169-050, Lisbon, Portugal. ronolosi@gmail.com
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Lopes da Silva
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D054219:Neoplasms, Plasma Cell / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000473:pathology*