Cytological Diagnosis of Metastasis from Plasma Cell Myeloma Presented As Forehead Swellings- An Unusual Case Report

Abstract

Multiple myeloma is a disease resulting from clonal proliferation of plasma cells. It often presents with bone pain, lytic bone lesions; spinal cord compression and peripheral neuropathy are less common presenting symptoms. Disease takes multiple forms that vary in treatment and prognosis and include multiple myeloma, solitary plasmacytoma, osteosclerotic myeloma. We present here the case of a 54 year old female who presented with multiple swellings on the forehead, she is a known case of multiple myeloma which was diagnosed in 2015. Aspirate from the swelling revealed immature plasma cells plasmablasts, flame cells, Ducther body and Russell bodies. The cells could be easily identified as plasma cells with their characteristic morphological appearance and therefore, the need for immunohistochemical analysis did not arise. Based on the cytological picture and reports of ancillary investigations, a diagnosis of metastasis from multiple myeloma was established. We are presenting this case because solitary lesions of multiple myeloma are rare in the head and neck area