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Plasmocytomas are neoplasms originating from plasma cells and can be subdivided into cutaneous extramedullary, non-cutaneous and multiple myeloma. The involvement of vertebrae can generate clinical signs of pain and neurological alterations according to the affected segment. The present study aims to report a case of extramedullary plasmacytoma in the thoracic spine and with consequent spinal cord compression in addition to metastasis sites, characterizing its clinicopathological aspects. The canine patient was hospitalized, submitted to laboratory and imaging tests, and medicated due to incoordination and loss of perception of limb positioning, but his clinical picture worsened, progressing to loss of movement and fecal and urinary incontinence, resulting in death. The main necropsy findings were the presence of a tumor mass along the external surface of the body of the fifth thoracic vertebra, in addition to light brown foci in the thoracic spinal cord and in the pulmonary and splenic parenchyma. Histologically, the tumor mass and light brown foci consisted of malignant cell proliferation, of plasmacytic origin, densely cellular and largely infiltrative. Thus, through the clinical picture presented, imaging tests and anatomopathological analysis, it was shown that it was a case of extramedullary plasmocytoma originating in the thoracic spine, with sites of metastasis in the spinal cord, lung and spleen.
Plasmocytomas are neoplasms originating from plasma cells and can be subdivided into cutaneous extramedullary, non-cutaneous and multiple myeloma. The involvement of vertebrae can generate clinical signs of pain and neurological alterations according to the affected segment. The present study aims to report a case of extramedullary plasmacytoma in the thoracic spine and with consequent spinal cord compression in addition to metastasis sites, characterizing its clinicopathological aspects. The canine patient was hospitalized, submitted to laboratory and imaging tests, and medicated due to incoordination and loss of perception of limb positioning, but his clinical picture worsened, progressing to loss of movement and fecal and urinary incontinence, resulting in death. The main necropsy findings were the presence of a tumor mass along the external surface of the body of the fifth thoracic vertebra, in addition to light brown foci in the thoracic spinal cord and in the pulmonary and splenic parenchyma. Histologically, the tumor mass and light brown foci consisted of malignant cell proliferation, of plasmacytic origin, densely cellular and largely infiltrative. Thus, through the clinical picture presented, imaging tests and anatomopathological analysis, it was shown that it was a case of extramedullary plasmocytoma originating in the thoracic spine, with sites of metastasis in the spinal cord, lung and spleen.
Resumo Plasmocitomas são neoplasmas originados de plasmócitos e podem ser subdivididos em extramedular cutâneo, não cutâneo e mieloma múltiplo. O envolvimento de vértebras pode gerar sinais clínicos de dor e alterações neurológicas de acordo com o segmento afetado. O presente estudo tem como objetivo relatar um caso de plasmocitoma extramedular em coluna vertebral torácica e com consequente compressão medular além de sítios de metástases, caracterizando seus aspectos clínico-patológicos. O paciente canino foi hospitalizado, submetido a exames laboratoriais e de imagem, e medicado devido a incoordenação e perda da percepção do posicionamento dos membros, mas apresentou piora do quadro clínico evoluindo para perda dos movimentos e incontinência fecal e urinária, ocorrendo o óbito. Os principais achados de necropsia foram a presença de massa tumoral junto à superfície externa do corpo da quinta vértebra torácica, além de focos pardo-claros na medula espinhal torácica e no parênquima pulmonar e esplênico. Histologicamente, a massa tumoral e os focos pardo-claros consistiam em proliferação celular maligna, de origem plasmocitária, densamente celular e amplamente infiltrativa. Assim, através do quadro clínico apresentado, exames de imagem e da análise anatomopatológica evidenciou tratar-se de um caso de plasmocitoma extramedular originado em coluna vertebral torácica, com sítios de metástase em medula espinhal, pulmão e baço.
Background: Myeloma-related disorders are characterized by proliferation of neoplastic plasma cell or immature immunoglobulin secreting B-lymphocytes, and include multiple myeloma, M-macroglobulinemia and extra-medullary plasmacytoma (cutaneous or extra-cutaneous). Solitary osseous plasmacytoma (SOP) is considered an unique entity among extra-medullary extra-cutaneous plasmacytoma. It is an unusual neoplasia in dogs, predominantly found in middle-aged to older animals, with a higher incidence in bones of axial skeleton. Dogs with vertebral SOP present neurological signs related to spinal cord compression, but progression to multiple myeloma is related to a poor outcome. As in humans, progression to multiple myeloma occurs in most cases, although it may take months or years from its initial presentation. SOP's biological behaviour, incidence and prognostic are rarely documented. Chemotherapy with melphalan and prednisolone represent the most used protocol for multiple myeloma. However, in SOP, the combination of chemotherapy with local approaches is controversial before the evidence of systemic disease. This paper aims at reporting a case of SOP in a lumbar vertebrae of a dog, with systemic involvement. Case: A 11-year old male mixed breed dog was attended presenting muscle weakness, lethargy, anorexia, adipsia and intense pain manifestation. The dog also presented multiple skin nodules, previously diagnosed as a plasmacytoma, through cytology. The dog's poor clinical condition and aggressive temper, associated with suspicious of an advanced myelomarelated disorder, resulted in the decision for humanized euthanasia. At necropsy, a pale, friable and hemorrhagic mass was identified on the L3 lumbar vertebrae, associated with an osteolytic bone lesion and spinal cord compression. Histopathological analyses revealed proliferation of plasma cells, with pale perinuclear halo, moderate cellular pleomorphism, 10 binucleated cells and 10 mitotic figures per 10 high power fields, compatible with extramedullary plasmacytoma of the mature type, in the lumbar vertebrae (SOP). It was also seen myeloma-related lesions in the skin and subcutaneous, prostate, heart, superficial mandibular and axillary lymph nodes Discussion: Solitary osseous plasmacytoma is a myeloma-related disorder rarely reported in dogs. Its biological behaviour is poorly characterized, however progression for multiple myeloma is common in humans and dogs, and it is related to a poor outcome. As the present report, systemic progression of SOP has been previously described and although an overt bone marrow infiltration was not detected, such possibility can not be excluded, once multiple myeloma distribution in the bone marrow is often multifocal. Although chemotherapy is the treatment of choice for multiple myeloma, its indication for SOP is conditioned to the evidence of systemic disease. It might delay tumour progression, but its early implementation may favor the selection of resistant neoplastic clones, making it ineffective when progression to multiple my...
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