Elsevier

Clinical Imaging

Volume 33, Issue 3, May–June 2009, Pages 240-243
Clinical Imaging

Case report
Extramedullary plasmacytoma of the pancreas and jejunum

https://doi.org/10.1016/j.clinimag.2008.12.006Get rights and content

Abstract

Plasmacytomas occurring in the gastrointestinal tract are extremely rare. We report one such case of pancreatic and jejunal plasmacytoma in a single patient with known multiple myeloma with emphasis on computed tomographic (CT) findings.

Introduction

Plasma cell neoplasms may present as multiple myeloma, solitary myeloma of the bone, plasma cell leukemia, or as extramedullary plasmacytoma (EMP) [1], [2]. Extramedullary plasmacytoma of the pancreas and gastrointestinal tract, either isolated or in association with multiple myeloma, is extremely rare [3], [4], [5], [6]. We report a very rare case of pancreatic and jejunal plasmacytoma in a single patient with known multiple myeloma with emphasis on computed tomographic (CT) findings. Such concurrence has not been reported before in radiology literature and, to the best of our knowledge, CT imaging features of jejunal involvement have not been described before.

Section snippets

Case report

A 59-year-old white male patient with light chain myeloma (IgA-K type) diagnosed by fine-needle aspiration of sternal mass 1 year ago was admitted with a rapid increase in the size of this mass and excruciating pain for radiation treatment and pain management. Multiple myeloma survey radiographs done at the time of initial diagnosis had also demonstrated additional bone involvement with lytic lesions in bilateral distal clavicles, right iliac bone, and right proximal femur. Serum and urine

Discussion

Plasma cell neoplasms may present as multiple myeloma, solitary myeloma of the bone, plasma cell leukemia, or as EMP [1], [2]. Extramedullary plasmacytomas are seen and can arise anywhere in the body, although the vast majority of cases occur in the head and neck with 80% occurring in the nasal cavity, paranasal sinuses, and upper airways. Involvement of the gastrointestinal tract is reported in approximately 10% of cases, most of which involve the liver and spleen [3], [4], [5], [6]. Very few

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