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
AFIP images
Plasmacytoma
Plasmacytoma
With crystalloids
With amyloid deposition
With blood lakes
With myxoid stroma
Plasmablastic plasmacytoma of nasopharynx
Anaplastic plasmacytoma
Immunohistochemistry
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
