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Published in: BMC Medical Imaging 1/2018

Open Access 01-12-2018 | Case report

Tonsillar Plasmacytoma: clues on magnetic resonance imaging

Authors: İrfan Çelebi, Gülpembe Bozkurt, Nedim Polat

Published in: BMC Medical Imaging | Issue 1/2018

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Abstract

Background

Malignant plasma cell proliferation may present as a disseminated disease (multiple myeloma), a solitary plasmacytoma of bone, or an extramedullary plasmacytoma of soft tissue. The latter plasmacytomas represent approximately 3% of all plasma cell proliferations, and 80% develop in the head-and-neck region. The unexpected clinical presentation of such masses may be present.

Case presentation

Here, we report a rare case of primary tonsillar plasmacytoma in a 42-year-old female. The patient presented with asymmetric tonsillar hypertrophy that was resistant to antibiotherapy. Upon further workup, we found no evidence of multiple myeloma or light-chain disease. The patient underwent surgery and, at the last follow-up, exhibited no evidence of such disease.

Conclusions

In adults presenting with asymptomatic tonsillar enlargement, the possibility of submucosal masses should be considered, thus encouraging the radiologist to evaluate crypts within the palatine tonsil on a postcontrast MRI, besides enlargement and signal change.
Literature
1.
go back to reference Susnerwala SS, Shanks JH, Banerjee SS, Scarffe JH, Farrington WT, Slevin NJ. Extramedullar plasmacytoma of the head and neck region: clinicopathological correlation in 25 cases. Br J Cancer. 1997;75:921–7.CrossRefPubMedPubMedCentral Susnerwala SS, Shanks JH, Banerjee SS, Scarffe JH, Farrington WT, Slevin NJ. Extramedullar plasmacytoma of the head and neck region: clinicopathological correlation in 25 cases. Br J Cancer. 1997;75:921–7.CrossRefPubMedPubMedCentral
2.
go back to reference Reiter ER, Randolph GW, Pilch BZ. Microscopic detection of occult malignancy in the adult tonsil. Otolaryngol Head Neck Surg. 1999;120:190–4.CrossRefPubMed Reiter ER, Randolph GW, Pilch BZ. Microscopic detection of occult malignancy in the adult tonsil. Otolaryngol Head Neck Surg. 1999;120:190–4.CrossRefPubMed
3.
go back to reference Miller FR, Lavertu P, Wanamaker JR, Bonafede J, Wood BG. Plasmacytomas of the head and neck. Otolaryngology—head and neck. Surgery. 1998;119:614–8. Miller FR, Lavertu P, Wanamaker JR, Bonafede J, Wood BG. Plasmacytomas of the head and neck. Otolaryngology—head and neck. Surgery. 1998;119:614–8.
4.
go back to reference Wiltshaw E. The natural history of extramedullary plasmacytoma and its relation to solitary myeloma of bone and myelomatosis. Medicine (Baltimore). 1976;55:217–38.CrossRef Wiltshaw E. The natural history of extramedullary plasmacytoma and its relation to solitary myeloma of bone and myelomatosis. Medicine (Baltimore). 1976;55:217–38.CrossRef
5.
go back to reference Galienia P, Cavi M, Pulsoni S, Avvisati G, Bigazzi C, Neri S, et al. Clinical outcome of extramedullary plasmacytoma. Haemtologica. 2000;85:47–51. Galienia P, Cavi M, Pulsoni S, Avvisati G, Bigazzi C, Neri S, et al. Clinical outcome of extramedullary plasmacytoma. Haemtologica. 2000;85:47–51.
6.
go back to reference Tokatli F, Puyan FO, Alas RC, Tuncbilek N, Uzal C. Extramedullary plasmacytoma: clinicopathology, immunohistochemistry and therapeutic approach to a case with a tonsillar site. Hematology/Oncology and Stem Cell Therapy. 2008;1:241–5.CrossRefPubMed Tokatli F, Puyan FO, Alas RC, Tuncbilek N, Uzal C. Extramedullary plasmacytoma: clinicopathology, immunohistochemistry and therapeutic approach to a case with a tonsillar site. Hematology/Oncology and Stem Cell Therapy. 2008;1:241–5.CrossRefPubMed
7.
go back to reference Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127:2375–90.CrossRefPubMedPubMedCentral Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127:2375–90.CrossRefPubMedPubMedCentral
8.
go back to reference Alexiou C, Kau RJ, Dietztelbinger H, Kremer M, Spiess JC, et al. Extramedullary plasmacytoma: tumor occurrence and therapeutic concepts. Cancer. 1999;85:2305–14.CrossRefPubMed Alexiou C, Kau RJ, Dietztelbinger H, Kremer M, Spiess JC, et al. Extramedullary plasmacytoma: tumor occurrence and therapeutic concepts. Cancer. 1999;85:2305–14.CrossRefPubMed
9.
go back to reference Sakai Y, Ikeya J, Morita I, Sato K. Extramedullary plasmacytoma of the tonsil diagnosed by fine-needle aspiration cytology. Ann Diagn Pathol. 2008;12:41–3.CrossRefPubMed Sakai Y, Ikeya J, Morita I, Sato K. Extramedullary plasmacytoma of the tonsil diagnosed by fine-needle aspiration cytology. Ann Diagn Pathol. 2008;12:41–3.CrossRefPubMed
10.
go back to reference Ridgway D, Wolff LJ, Neerhout RC, Tilford DL. Unsuspected nonHodgkin’s lymphoma of the tonsils and adenoids in children. Pediatrics. 1987;79:399–402.PubMed Ridgway D, Wolff LJ, Neerhout RC, Tilford DL. Unsuspected nonHodgkin’s lymphoma of the tonsils and adenoids in children. Pediatrics. 1987;79:399–402.PubMed
11.
go back to reference Cortez EA, Maltox DE, Holt GR, Gates GA. Unilateral tonsil enlargement. Otolaryngol Head Neck Surg. 1979;87:707–16.CrossRefPubMed Cortez EA, Maltox DE, Holt GR, Gates GA. Unilateral tonsil enlargement. Otolaryngol Head Neck Surg. 1979;87:707–16.CrossRefPubMed
12.
go back to reference Cinar F. Significance of asymptomatic tonsil asymmetry. Otolaryngol Head Neck Surg. 2004;131:101–3.CrossRefPubMed Cinar F. Significance of asymptomatic tonsil asymmetry. Otolaryngol Head Neck Surg. 2004;131:101–3.CrossRefPubMed
13.
go back to reference Spinou C, Kubba H, Konstantinidis I, Johnston A. Role of tonsillectomy in histology for adults with unilateral tonsillar enlargement. Br J Oral Maxillofac Surg. 2005;43:144–7.CrossRefPubMed Spinou C, Kubba H, Konstantinidis I, Johnston A. Role of tonsillectomy in histology for adults with unilateral tonsillar enlargement. Br J Oral Maxillofac Surg. 2005;43:144–7.CrossRefPubMed
14.
go back to reference D’Aguillo C, Soni RS, Gordhan C, Liu JK, Baredes S, Eloy JA. Sinonasal extramedullary plasmacytoma: a systematic review of 175 patients. Int Forum Allergy Rhinol. 2014;4:156–63.CrossRefPubMed D’Aguillo C, Soni RS, Gordhan C, Liu JK, Baredes S, Eloy JA. Sinonasal extramedullary plasmacytoma: a systematic review of 175 patients. Int Forum Allergy Rhinol. 2014;4:156–63.CrossRefPubMed
15.
go back to reference Kwee TC, Kwee RM, Nievelstein RA. Imaging in staging of malignant lymphoma: a systematic review. Blood. 2008;111:504–16.CrossRefPubMed Kwee TC, Kwee RM, Nievelstein RA. Imaging in staging of malignant lymphoma: a systematic review. Blood. 2008;111:504–16.CrossRefPubMed
16.
go back to reference Terada T. Primary extramedullary malignant plasmacytoma mimicking carcinoma of rectum. Case Reports in Clinical Pathology. 2016;3:6–10.CrossRef Terada T. Primary extramedullary malignant plasmacytoma mimicking carcinoma of rectum. Case Reports in Clinical Pathology. 2016;3:6–10.CrossRef
17.
go back to reference Soutar R, Lucraft H, Jackson G, Reece A, Bird J, Low E, et al. Guidelines on the diagnosis and management of solitary plasmacytoma of bone and solitary extramedullary plasmacytoma. Br J Haematol. 2004;124:717–26.CrossRefPubMed Soutar R, Lucraft H, Jackson G, Reece A, Bird J, Low E, et al. Guidelines on the diagnosis and management of solitary plasmacytoma of bone and solitary extramedullary plasmacytoma. Br J Haematol. 2004;124:717–26.CrossRefPubMed
Metadata
Title
Tonsillar Plasmacytoma: clues on magnetic resonance imaging
Authors
İrfan Çelebi
Gülpembe Bozkurt
Nedim Polat
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Medical Imaging / Issue 1/2018
Electronic ISSN: 1471-2342
DOI
https://doi.org/10.1186/s12880-018-0261-9

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