Table of Contents
Definition / general | Case reports | Treatment | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Molecular / cytogenetics description | Differential diagnosisCite this page: DePond W. Plasmacytoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lymphnodesplasmacytoma.html. Accessed February 7th, 2023.
Definition / general
- 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
- 65 year old man with cervical and submandibular node involvement (Korean J Intern Med 2005;20:183)
- 81 year old man with Sjögren syndrome (Pathol Int 1999;49:577)
- Patient with Castleman disease (Arch Pathol Lab Med 1986;110:157, Am J Clin Pathol 1982;78:541)
Treatment
- Surgery and radiotherapy
Microscopic (histologic) description
- Similar to plasmacytomas outside lymph node
- Dense, monotonous infiltrate of plasma cells that effaces nodal architecture
- Cells vary from mature to binucleated to anaplastic
- Plasmablastic if amphophilic to basophilic cytoplasm with small Golgi zone and large vesicular nuclei with prominent central nucleoli
- Anaplastic if marked pleomorphism and irregular foldings in nuclear membranes
- May have amyloid deposits
Microscopic (histologic) images
Positive stains
Molecular / cytogenetics description
- Negative for KSHV / HHV8
Differential diagnosis
- Castleman disease: plasma cell variant
- Lymphoplasmacytic lymphoma: also has neoplastic small lymphocytes
- Other low grade lymphomas with plasmacytic differentiation
- Reactive plasmacytosis: often follicular hyperplasia, no light chain restriction