A case report of extramedullary plasmacytoma - Presenting as a chest wall tumour

Abstract

Plasmacytoma refers to a malignant plasma cell tumor growing within soft tissue or within the axial skeleton. Plasmacytoma accounts for six percent of all primary chest wall tumours. A solitary extramedullary plasmacytoma is reported three percent of plasma cell disorders. A 65 year male patient presented with complaint of swelling in the back of right side of the chest noticed for one month, pain over the swelling and dry cough for two weeks. Physical examination revealed a diffuse, lobulated swelling in the back of right side of chest which is firm to hard in consistency. The chest radiograph showed a large extra-pulmonary opacity with well-defined medial margin and lateral margin merging with chest wall on right side and blunting of the right costophrenic angle. The histopathological examination of tru-cut biopsy section showed fragments of fibrocartilagenous stroma infiltrated by mononuclear cells with round to oval nucleus and eosinophilic cytoplasm and some foci showed plasmocytoid features with the intervening stroma shows proliferating capillaries thereby features suggestive of plasmacytoma. The specimen is positive for CD 138 by the immunohistochemistry analysis which is the hallmark for diagnosing plasmacytoma.

Keywords

• extramedullary plasmacytoma
• tru-cut biopsy
• immunohistochemistry.