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Primary intracranial plasma cell granulomas presenting as malignant neoplasms

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Abstract

Plasma cell granuloma (PCG) is an uncommon non-neoplastic mass lesion of unknown etiology. It is characterized by a polyclonal proliferation of chronic inflammatory cells, mostly mature plasma and other mononuclear cells. PCGs arising in the central nervous system are particularly rare. We report two additional cases of intracranial PCG exclusively involving the brain parenchyma. A 47 year-old woman, presenting with partial motor seizures and fluent aphasia, underwent complete excision of a well-demarcated, enhancing left parietal mass. The second patient was a 56 year-old man presenting with headaches and right-sided weakness who underwent stereotactic biopsy of an ill-defined, heterogeneously enhancing lesion in the left basal ganglia. Immunohistochemical analysis of surgical specimens showed polyclonal plasma cells and mature lymphocytes but no etiological agent. A histopathologic diagnosis of intracranial PCG was made in both cases. PCG should be part of the differential diagnosis of enhancing mass lesions of the brain. The etiology and natural history of these tumor-like lesions is not fully understood. Complete surgical excision appears to be curative. Lesions where total resection is not possible may benefit from adjuvant treatment including corticosteroids and possibly radiation therapy.

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Acknowledgments

We would like to thank Dr. Monika Mittal and Mr. Brandon Parker in the Department of Neurosurgery for editorial assistance.

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Authors and Affiliations

  1. Department of Neurology, Wayne State University, Detroit Medical Center, Detroit, MI, USA

    Preeti Puntambekar, Sunitha Santhakumar & Alexandros Tselis

  2. Department of Pathology, Wayne State University, Detroit Medical Center, Detroit, MI, USA

    William J. Kupsky

  3. Karmanos Cancer Institute, Detroit, MI, USA

    William J. Kupsky & Sandeep Mittal

  4. Department of Neurosurgery, Wayne State University, Detroit Medical Center, 4160 John R Street, Suite 930, Detroit, MI, 48201, USA

    Sandeep Mittal

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  1. Preeti Puntambekar
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  2. Sunitha Santhakumar
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  5. Sandeep Mittal
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Correspondence to Sandeep Mittal.

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Puntambekar, P., Santhakumar, S., Kupsky, W.J. et al. Primary intracranial plasma cell granulomas presenting as malignant neoplasms. J Neurooncol 106, 327–337 (2012). https://doi.org/10.1007/s11060-011-0667-5

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  • DOI: https://doi.org/10.1007/s11060-011-0667-5

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