Small-Cell Plasmacytoma With Prominent Myxoid Stroma Mimicking a Soft-Tissue Neoplasm

Background Plasmacytomas are rare tumors comprised of neoplastic monoclonal plasma cells and can be found anywhere in the body. Plasmacytomas that involve the nervous system can give rise to diffuse symptoms depending on their location. Patients with confusion or dementia might be difficult to neurologically assess in an acute setting and the subtle symptoms of neurological pathology caused by rare malignancies might go undiagnosed. Case presentation The patient is an 80 year old man presenting to the ER with walking difficulties, pain, and confusion. He underwent neurological evaluation for dementia and was eventually diagnosed with possible Alzheimer’s disease and a malignant plasmacytoma causing spinal cord compression. His CSF sample showed normal amyloid rate and very low Aβ. Following rehabilitation and oncological treatment, his walking ability and confusion improved. Conclusion This case is unique as we demonstrate that spinal cord compression by plasmacytoma can lead to abnormal CSF levels of several known pathology markers for Alzheimer’s disease and neuronal damage. We suggest that highly divergent amyloid CSF levels could be indicative of spinal pathologies affecting CSF circulation. We also suggest closer assessment of elderly confusion patients in ER settings by consultants specialized in neurological disorders.

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Confusion, cognitive impairment, and spinal cord compression caused by plasmacytoma: a case report

Axenhus

Bogdanović

2021

BMC Neurol

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B-cell lymphoma with pseudopapillary features, myxoid changes and lack of CD20 expression: a diagnostic pitfall

Raciti¹,

Allen²,

Mears

et al. 2015

Leukemia & Lymphoma

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Small-Cell Plasmacytoma With Prominent Myxoid Stroma Mimicking a Soft-Tissue Neoplasm

Cited by 2 publications

References 8 publications

Confusion, cognitive impairment, and spinal cord compression caused by plasmacytoma: a case report

Confusion, cognitive impairment, and spinal cord compression caused by plasmacytoma: a case report

B-cell lymphoma with pseudopapillary features, myxoid changes and lack of CD20 expression: a diagnostic pitfall

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