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Breast malignant, males, children

Other malignancies

Plasmacytoma


Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 17 November 2012, last major update August 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

Definition
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● Neoplasm of plasma cells, either primary to breast or secondary (most cases) to a systemic process or another plasmacytoma

Terminology
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● Not part of WHO breast classification

Clinical features
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● Rare
● May progress to multiple myeloma after years of remission
● Frozen section diagnoses are often incorrect - resembles lobular or poorly differentiated tumor, but with a grossly well circumscribed appearance

Case reports
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● 27 year old woman with coexisting ductal carcinoma (World J Surg Oncol 2009;7:43)
● 37 year old woman with only breast involvement (Arch Pathol Lab Med 2001;125:1078)
● 70 year old woman with recurrence of mediastinal disease in bilateral breasts (World J Surg Oncol 2004;2:29)
● 78 year old man with breast and axillary nodal involvement (Clin Breast Cancer 2006;7:81)
● Patient with disease free survival of 9+ years (Arch Pathol Lab Med 1984;108:676)

Clinical images
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Well-defined mass with irregular borders

Micro description
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● Immature and mature plasma cells with nuclear pleomorphism
● Also binucleated and multinucleated forms, mitotic figures and necrosis

Micro images
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Plasma cells, some binucleated,   Nuclear pleomorphism, binucleated and
surrounding benign lobules     multinucleated plasma cells with enlarged nucleoli


Tumor in HIV+ man

         
Plasma cells (long arrows),      Dense infiltrate of plasma cells
Russell bodies (short arrow)    and lymphocytes (AFIP)
and lymphocytes

         
With ductal carcinoma       Her-2 negtive

         
Plasma cells are IgA+        Monoclonal lambda staining
and kappa light chain+

         
Kappa staining            Diffuse Ki-67 nuclear staining

Cytology description
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● Dispersed population of plasmacytoid cells at various stages of maturation (Acta Cytol 2003;47:1107)
● Mature plasma cells have an eccentric nucleus and abundant deep basophilic cytoplasm with a paranuclear halo
● Plasmablasts (immature plasma cells) have a prominent eccentric nucleus with a single large nucleolus and abundant deep basophilic cytoplasm with no paranuclear halo
● Also binucleate and multinucleate forms (Acta Cytol 1997;41:364)

Differential diagnosis
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Plasma cell mastitis: no light chain restriction
Melanoma
MALT lymphoma

End of Breast malignant, males, children > Other malignancies > Plasmacytoma


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