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Bladder
Other tumors
Plasmacytoma
Reviewers: Gillian Levy, M.D., Yale Medical Center Reviewers page)
Last Revised: 13 June 2011, last major update April 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.
Definition
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● Neoplastic proliferation of plasma cells; may be associated with multiple myeloma
● Plasma cell neoplasm composed of plasma cells in any stage of differentiation
Epidemiology
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● Rare in bladder
Etiology
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● Most patients have known multiple myeloma or develop multiple myeloma
Clinical features
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● Tumors look and act like solid tumors
● May be associated with serum and urine monoclonal immunoglobulins
● May recur, usually don’t cause death
Case reports
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● 36 year old woman with post-transplantation tumor (Int J Hematol 2005;81:255)
● 95 year old woman with bladder mass (Acta Cytol 2006;50:339)
Gross description (Macroscopy)
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● Single or nodular mass of bladder wall
Micro description (Histopathology)
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● Mature and immature plasmacytoid forms, including giant cells
● Tumor cells have typical plasma cell morphology with eccentric nuclei and perinuclear hoffs or can be atypical with giant cells
Micro images
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Plasmacytoma
Tumors (left to right) of adrenal gland, nasopharynx, lung, testis
Kappa light chain staining
Cytology description
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● Urine histiocytes may contain immunoglobulin crystals (Diagn Cytopathol 2004;31:48)
Cytology images
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Touch prep (left to right): lymph node/spleen; nasopharynx
Positive stains
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● CD138+, weakly positive for CD20 and CD45RB, variably positive for EMA; may express IgA or IgM
● Restricted light chain expression (kappa or lambda but not both)
Negative stains
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● Keratin
Electron microscopy images
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Stomach tumor: Russell bodies consist of numerous cytoplasmic granules composed of aggregates of membranes
Differential Diagnosis
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● Plasmacytoid urothelial carcinoma: usually advanced stage with nodal metastases, areas of classic urothelial carcinoma, small intracytoplasmic vacuoles, keratin+ (CK7, AE1-AE3, CAM5.2), variable CK20, often CD138+ (Hum Pathol 2009;40:1023,
Am J Surg Pathol 2009;33:417)
● Malignant lymphoma: B cell tumors are CD20+, only weakly positive or negative for kappa or lambda, and variable positivity for CD138
Additional references
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End of Bladder > Other tumors > Plasmacytoma
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