Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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January 29, 2015
Extramedullary Plasmacytoma
- Plasma cell neoplasm is classified into three categories: the disseminated form, multiple myeloma, and the localized forms of medullary and extramedullary plasmacytomas. The last variant, solitary extramedullary plasmacytoma (SEP), accounts for less than 2% of all neoplastic plasma dyscrasias and occurs in any part of the body, especially in the head and neck. About 75–80% of these tumors originate in the submucosa of the upper aerodigestive tract; of these, 75% involve the nasal tract.
- Key Diagnostic Features
- Typically, a mass or infiltrative lesion with soft-tissue attenuation on CT scan
- Isointense and hyperintense on T1- and T2-weighted MR images, respectively
- They reveal moderate-to-marked enhancement and may have associated lytic bone destruction
- DDx
- Esthesioneuroblastoma
- Squamous cell cancer
- Non-Hodgkin lymphoma
- Sinonasal undifferentiated carcinoma
- Extracranial nasal meningioma
- Rx
- Radiation therapy
- Surgery
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