Primary Pancreatic Plasmacytoma

Abstract

We report an extremely rare case of primary pancreatic plasmacytoma. A 56-year-old man had a 4-cm mass in the pancreatic tail and received distal pancreatectomy. This mass mainly consisted of plasma cells, but we failed to demonstrate their monoclonality in spite of the immunohistological staining. One and a half years later, this patient's right inguinal node swelled, and this node also showed a dense plasma cell infiltration. A very precise immunohistological staining was performed for this lymph node and the previous pancreatic mass, and both were diffusely positive for kappa light chain, IgG, and CD38. In the absence of myeloma elsewhere, we thus reached the correct diagnosis of primary pancreatic plasmacytoma, which later metastasized to lymph nodes. In the presence of the plasma cell proliferation in a pancreatic mass, plasmacytoma should be taken into consideration, and a more careful immunohistological staining is definitely necessary.

Extramedullary Plasmacytoma of the Pancreas: A Rare Entity

“…They are usually diagnosed after multiple myeloma of the bone marrow. Although the majority of extramedullary plasmacytomas involve the upper respiratory tract, ten percent occur in the gastrointestinal tract, primarily the liver, spleen, or stomach [2, 3]. …”

Extramedullary plasmacytoma of the pancreas as an uncommon cause of obstructive jaundice: a case report

“…Surgical procedures, other than distal pancreatectomy for isolated pancreatic tail involvement, are not commonly performed owing to the often systemic nature of the disease and the radical nature of these surgical procedures [4]. Unsuspected cases may undergo pancreatic resection typical for pancreatic lesions with subsequent identification of plasma cells [10]. Chemotherapeutic agents are commonly used, particularly when plasmacytomas are secondary in nature.…”

Pancreatic Involvement by Plasma Cell Neoplasms

“…However, in cases on non-upper aerodigestive tract EMP, it appears that no statistical difference in survival is observed [6]. In the literature, cases with multifocal or bulky pancreatic involvement have been managed with combined RT plus surgery or, in selected cases of isolated pancreatic tail mass, surgery alone (distal pancreatectomy) [20,24,33,34,42,45,56]. Surgical procedures, other than distal pancreatectomy for isolated pancreatic tail involvement, are not commonly performed owing to the often systemic nature of the disease and the radical nature of these surgical procedures.…”

“…Surgical procedures, other than distal pancreatectomy for isolated pancreatic tail involvement, are not commonly performed owing to the often systemic nature of the disease and the radical nature of these surgical procedures. Unsuspected cases may undergo pancreatic resection typical for pancreatic lesions with subsequent identification of plasma cells [45].…”