Case Report: PDF Only

Primary plasmacytoma involving mediastinal lymph nodes

A diagnostic mimicry of primary mediastinal lymphoma

Salem, Karma Z.a,b,1; Nishihori, Taigaa,c,1; Kharfan-Dabaja, Mohamed A.a,c,*; Horna, Pedroc,d; Alsina, Melissaa,c

Author Information

aDepartment of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

bFaculty of Medicine, American University of Beirut, Beirut, Lebanon

cDepartment of Oncologic Sciences, University of South Florida College of Medicine, Tampa, FL, USA

dDivision of Hematopathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

Corresponding author at: Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Faculty Office Building-3, Tampa, FL, USA. Tel.: +1 813 745 8248; fax: +1 813 745 8468. E-mail address:[email protected] (M.A. Kharfan-Dabaja).

1 These authors contributed equally to the manuscript.

Received March 17, 2015

Accepted June 01, 2015

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Hematology/Oncology and Stem Cell Therapy 9(1):p 26-29, Jan–Mar 2016. | DOI: 10.1016/j.hemonc.2015.06.007
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Abstract

Plasmacytomas could involve any organ, and at times might pose a diagnostic challenge when the site of involvement is unusual, or if the presentation is similar to other diseases. Wedescribe a 48-year-old man presenting with worsening shortness of breath and chest discomfort with radiologic evidence of mediastinal enlargement, mimicking a lymphoma with mediastinal involvement. An excisional biopsy of a mediastinal lymph node showed a plasma-cell infiltrate strongly positive for CD138, with a flow-cytometry analysis showing a population of lambda-restricted neoplastic plasma cells. He failed to respond to 50 Gy involved-field radiotherapy, but achieved a partial response to combination chemotherapy. He underwent high-dose chemotherapy with melphalan (200 mg/m2) followed by lenalidomide maintenance, and is in complete remission 18 months postautografting. This case illustrates a unique and rare presentation of primary lymph-node plasmacytomas involving the mediastinum potentially mistaken as lymphoid malignancy. Clinicians should be aware of the plasma-cell origin of the mediastinal neoplastic process.

© 2016 Hematology/Oncology and Stem Cell Therapy | Published by Wolters Kluwer – Medknow
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