Primary Plasmacytoma of Thyroid Gland—an Interesting Case Diagnosed By FNAC

Abstract

Introduction: Primary plasmacytoma of the thyroid gland is a rare disease. Extramedullary plasmacytoma (EMP) comprises 3-5% of all plasma cell neoplasm. Case report: A 57-yearsold female presented with a large thyroid swelling involving the left lobe and isthmus, firm in consistency and moved a little with deglutition. CT scan revealed a large solid tumor (9.5 cm in greatest dimension) affecting thyroid gland. CT scan report gave differential diagnoses of plasmacytoma and metastatic carcinoma. FNAC revealed hypercellular smears composed of plasma cells with eccentrically placed nuclei and perinuclear hoff. Hematological work up and other relevant investigations including urine for Bence Jones protein ruled out multiple myeloma or other plasma cell dyscrasias. Subsequent histopathological examination and IHC (immunohistochemistry) confirmed the diagnosis of primary plasmacytoma of thyroid. Discussion: EMP can present with elevated anti thyroid antibodies and can be associated with lymphocytic thyroiditis; however, in our patient these findings were not present.

Fine‐needle aspiration cytology for the diagnosis of plasma cell neoplasms in the head and neck region: A systematic analysis of the literature

“…The electronic searches yielded 1143 articles (PubMed: 418, Web of Science: 292, Embase: 265, and Scopus: 168) and 82 studies reporting 102 individuals were included in this systematic review 17–98 (Figure 1).…”

“…Most cases were primary and extraosseous lesions. However, both extraosseous and intraosseous lesions result in a variety of findings, including swelling associated or not with pain, facial asymmetry, numbness, paraesthesia, and hoarseness 17–98 . Notably, the findings indicated that most cases had a diagnosis of plasmacytoma (extramedullary or solitary of bone) and the remaining ones had systemic involvement by PCM.…”

“…A recent systematic review identified concordance rates higher than 64% for the smear and 77% for the cell‐block technique regarding diagnostic capability for the evaluation of intraosseous jaw lesions, including malignant lesions 16 . Despite several published reports on the cytopathological diagnosis of PCN, either in isolated manifestations (extramedullary or solitary bone plasmacytoma) or as a consequence of PCM, 17–98 there is a lack of compiled information investigating the agreement of cytopathological and histopathological findings, along with others ancillary cytological methods such as smears and cell blocks. In fact, FNAC represents a faster, cheaper and more diversified noninvasive diagnostic approach.…”