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Lymphoma - B cell neoplasms

Plasma cell neoplasms

Plasmacytoma

Reviewer: Nikhil Sangle, M.D., University of Utah and ARUP Laboratories (see Reviewers page)
Revised: 16 March 2011, last major update March 2011
Copyright: (c) 2001-2011, PathologyOutlines.com, Inc.

Definition
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● Plasma cell neoplasm that forms discrete mass

Clinical features
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● Constitutes 3–5% of plasma cell neoplasms
● Isolated plasma cell neoplasm, usually of bone or soft tissue (oropharynx), composed of terminally differentiated B cells
● Either solitary plasmacytoma of bone, extramedullary plasmacytoma or primary lymph node plasmacytoma

Extramedullary plasmacytoma:
● Arises outside bone marrow; often in nasal cavity, nasopharynx, sinuses, oropharynx, lung or any other body site
● May recur locally, but only infrequently progresses to myeloma, less often than solitary plasmacytomas of bone
● Morphologic features similar to solitary plasmacytoma of bone

Primary lymph node plasmacytoma:
● Rare, must exclude metastatic multiple myeloma (40% of high stage myelomas metastasize to lymph nodes), metastatic upper respiratory tract plasmacytomas (15% metastasize to cervical lymph nodes) and Castleman’s disease
● Often involves cervical nodes, mean 5 cm, 40% had serum monoclonal proteins, most patients had localized disease and were cured after local excision or radiation, similar to other extramedullary plasmacytomas (Am J Clin Path 2001;115:119)

Case reports
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● Extramedullary plasmacytomas associated with amyloidoma (Arch Pathol Lab Med 2002;126:969), in breast (Arch Pathol Lab Med 2001;125:1078)

Treatment
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● Local radiation

Gross images
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Metastasis to myocardium

Micro description
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● Lymph nodes: effacement by mature plasma cells, with no/rare lymphocytes or immunoblasts

Microscopic images
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Atypical plasma cells

   
Metastases to myocardium


Various images


Cutaneous plasmacytoma


Plasmablastic plasmacytoma

Differential diagnosis
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● Myeloma: plasma cells are usually more anaplastic
● Plasmacytosis: no light chain restriction of plasma cells

End of Lymphoma - B cell neoplasms > Plasma cell neoplasms > Plasmacytoma

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