Primary Pulmonary Plasmacytoma

Epidemiology

  • Extremely rare

Physiology

  • Primary plasmacytoma in lung
  • Lung plasmacytoma may precede onset of overt Multiple Myeloma

Diagnosis

  • CXR/Chest CT Pattern:
    1) Parenchymal mass/ nodule: usually poorly circumscribed
    2) Pleural effusion:

Skeletal X-ray survey: diffuse osteopenia/ lytic bone lesions

BM Bx: positive in vast majority of cases

SPEP/ UPEP/ IEP: necessary to document monoclonal gammopathy

Bone FNA: may be useful for diagnosis
-Immunohistochemical stains: positive for monoclonal surface immunoglobulin


Clinical

(usually asymptomatic)

  • Dyspnea: may occur in cases with pleural effusion
  • Other: fatigue/ bone pain/ fever/ weight loss

Treatment

  • True solitary plasmacytoma: treated with surgical excision or XRT
  • Treatment of pleural effusion

Prognosis

  • Good for true solitary pulmonary plasmacytoma