Lymph nodes & spleen, nonlymphoma

Lymph node & spleen-nonlymphoid neoplasms

Plasmacytoma



Last author update: 27 March 2023
Last staff update: 27 March 2023

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PubMed Search: Plasmacytoma lymph nodes

Patricia Tsang, M.D., M.B.A.
Nat Pernick, M.D.
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Cite this page: Tsang P, Pernick N. Plasmacytoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lymphnodesplasmacytoma.html. Accessed April 14th, 2024.
Definition / general
  • This topic only discusses features of plasmacytoma in lymph nodes different from plasmacytoma and myeloma
  • Very rare (< 50 reported cases)
  • Diagnosis of primary plasmacytoma of lymph node requires exclusion of extramedullary plasmacytoma (15% of upper respiratory tract plasmacytomas metastasize to cervical nodes) and myeloma (40% of high stage myelomas metastasize to nodes)
  • 2/3 male; median age 59 years (range 39 - 76 years)
  • Often involves cervical nodes
  • Similar survival to other extramedullary plasmacytomas, although does not progress to myeloma (Am J Clin Pathol 2001;115:119, Hum Pathol 1997;28:1083)
Case reports
Microscopic (histologic) images

AFIP images

Plasmacytoma

Plasmacytoma

With crystalloids

With amyloid deposition


With blood lakes

With myxoid stroma

Plasmablastic plasmacytoma of nasopharynx

Anaplastic plasmacytoma

Immunohistochemistry

Differential diagnosis
  • Castleman disease, plasma cell variant
  • Lymphoplasmacytic lymphoma:
    • Also has neoplastic small lymphocytes
    • Often shows IgM restriction and MYD88 gene mutation
  • Marginal zone lymphoma:
    • May have plasmacytoid features but more extensive sampling may reveal B cell component
    • CD20 expression by neoplastic B cells and plasmacytoid cells
    • Clonal B cell population by flow; molecular or cytogenetic features of marginal zone lymphoma
  • Large cell lymphoma:
    • May have immunoblastic or plasmablastic features
  • Plasma cell myeloma with nodal involvement:
    • Must be excluded by radiographs, bone marrow biopsy
  • Plasmablastic lymphoma:
    • Mostly extranodal; less frequent nodal involvement
    • Associated with HIV or other immunosuppressive states and EBV
  • Reactive plasmacytosis:
    • Often follicular hyperplasia
    • No light chain restriction
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