Plasma Cell Myeloma Presenting as Abnormal Uterine Bleeding
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Abstract:
We report a case of a 53-year-old woman who presented with anemia and abnormal uterine bleeding. Endometrial and cervical biopsies revealed infiltration by large atypical cells, which were characterized as neoplastic plasma cells. Further investigations revealed systemic plasma cell dyscrasia (i.e., plasma cell myeloma). We therefore report a case of plasma cell myeloma, initially presenting as abnormal uterine bleeding.Keywords:
Plasma cell dyscrasia
Plasma Cell Myeloma
Dyscrasia
Infiltration (HVAC)
Plasma cell neoplasm
To present a case of extramedullary plasmacytoma localized in the kidney. The clinical features, diagnostic tests, treatment and outcome are discussed.A 59-year-old patient presented with a right renal mass and renal failure. The complementary tests showed a lambda monoclonal band in blood and urine, and a left renal biopsy showed changes compatible with myeloma. The definitive diagnosis of plasmacytoma was based on the findings of open renal biopsy since fine needle punction findings were compatible with a carcinoma. The patient received polychemotherapy, but died one year after the diagnosis due to a rapidly progressing plasmatic cell dyscrasia.Renal plasmacytoma is rare and should be suspected when paraprotein is detected in blood and urine, and when the patient has a history of plasmatic cell dyscrasia. There is no widely-established treatment. Surgery, radiotherapy or chemotherapy, alone or in combination, can be utilized.
Plasma cell dyscrasia
Dyscrasia
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• Extramedullary plasmacytoma is a malignant plasma cell dyscrasia that is most commonly found in the head and neck. Progression to disseminated disease in the form of multiple myeloma occurs in 17% to 32% of cases. Herein, we describe a patient with extramedullary plasmacytoma of the thyroid gland in whom a serum monoclonal gammopathy resolved with surgery and irradiation of the primary. Although rare, this diagnosis should be considered in patients presenting with obstructive thyromegaly and autoimmune thyroiditis. (Arch Otolaryngol Head Neck Surg. 1990;116:855-859)
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Extramedullary plasmacytoma
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Monoclonal gammopathy
Bence Jones protein
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Direct measurement of monoclonal plasma cell mass in bone marrow biopsies may be a useful parameter to establish in plasma cell dyscrasia. In this study monoclonal plasma cells/mm in light chain immunoglobulin immunostained archival bone marrow sections from 22 patients in whom a diagnosis of multiple myeloma (MM) had been excluded but who had monoclonal proteins were counted by two observers at light microscopic level. There was good correlation between the counts of the two observers. The levels of monoclonal plasma cells/mm in biopsies were not related to the % counts in the aspirates taken at the same time as the biopsies. Three of seven patients with biopsy levels in excess of the polyclonal levels in patients without plasma cell dyscrasia developed progressive MM within the observation time. Monoclonal plasma cell levels/mm of bone marrow biopsies can be measured and they provide a useful parameter for the assessment of patients with low volume plasma cell dyscrasia.
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Dyscrasia
Plasma cell neoplasm
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Plasma cell dyscrasia is a result of an abnormal clonal proliferation of plasma cells. These cells arise from B cells in the bone marrow and produce immunoglobulins. Multiple myeloma is a type of plasma cell dyscrasia that commonly presents with symptoms secondary to hypercalcemia, hyperviscosity, renal failure, and bone pain. Here, we report three patients with unusual presentations of plasma cell dyscrasias.
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Dyscrasia
Hyperviscosity
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Plasma Cell Myeloma
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Abstract Solitary neoplastic proliferation of plasma cells (plasmacytoma) rarely occurs in the central nervous system. The longest follow‐up in nine previously reported patients was 5 years. We have followed two patients with solitary intracranial plasmacytoma for 8 and 13 years, respectively. At the time of biopsy diagnosis, neither showed involvement of the adjacent calvarium or evidence of a systemic plasma cell dyscrasia. The first patient underwent partial excision of a mass in the right occipital lobe that showed no gross or microscopic involvement of the dura. The second patient had partial resection of a mass arising from dura and invading the left temporal lobe. Postoperative irradiation was given to both patients. No clinical or radiological sign of recurrent brain tumor has developed in either patient during the extended follow‐up period. Neither patient has had laboratory or clinical evidence of a systemic plasma cell dyscrasia. Solitary intracranial plasmacytoma may be a “curable” brain tumor.
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Dyscrasia
Plasma cell dyscrasia
Plasma cell neoplasm
Plasma cell leukemia
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Plasma cell leukaemia (PCL) is a very rare plasma cell dyscrasia with a significant number of monoclonal plasma cells in the peripheral blood. It is diagnosed by the presence of ≥ 2x109 /L plasma cells in the blood or by plasma cells making up ≥20% of the leukocyte count. It can arise from a leukemic transformation of multiple myeloma, or more commonly it can be primary. Regardless of its origin, it carries a very dire prognosis. It responds very poorly to the traditional chemotherapy regimens used for multiple myeloma. We present the case of a 50 years old female who presented to our hospital with a complicated UTI and severe generalized body aches. She was diagnosed as a case of plasma cell leukaemia and was treated with cyclophosphamide and dexamethasone, however she failed to go into remission. Her condition deteriorated and she ultimately passed away 1.5 months after diagnosis. The recommended treatment for PCL is aggressive combination chemotherapy followed by stem cell transplantation. However, there is no consensus regarding the treatment of plasma cell leukaemia, and treatment should be individualized based on the patient profile. Once diagnosed, the prognosis is poor.
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Plasma cell dyscrasias are characterized by neoplastic proliferation of a single clone of plasma cells typically producing a monoclonal immunoglobulin. Plasma cell neoplasms can present as a single lesion (solitary plasmacytoma) or more commonly as multiple lesions (multiple myeloma). Plasmacytomas can be present at the initial diagnosis of multiple myeloma or develop later during the course of the disease.
When plasmacytoma is associated with 10 percent or more clonal plasma cells in the bone marrow, the diagnosis is considered to be multiple myeloma rather than solitary plasmacytoma. While solitary plasmacytomas are treated with radiotherapy, multiple myeloma is treated with chemotherapy.
Plasma cell neoplasm
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clone (Java method)
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Present clinical and laboratory diagnostic criteria permit a more accurate diagnosis and closer follow-up of patients with plasma cell dyscrasias. A ten-year follow-up of a group of 423 patients showed that the indications for and the adjustment of treatment are more precise when these criteria are summarized into profiles based on each diagnostic category. M components may be an indication of the presence of another sometimes nonreticular malignant neoplasm. The improvement of the specificity and sensitivity of immunologic methods sheds additional light on mechanisms controlling the synthesis of homogeneous antibodies such as prevalence of IgM-κ in mixed cryoglobulinemia and λ-light chains in IgD myeloma, excretion of λ-Bence Jones proteins in amyloidosis, and greater IgG-subclass restriction in multiple myeloma as compared with benign monoclonal gammopathy. The activation of additional clones (biclonal gammopathies) was found in 3% of our patients. (JAMA241:2275-2278, 1979)
Dyscrasia
Plasma cell dyscrasia
Bence Jones protein
Monoclonal gammopathy
Immunoglobulin D
Plasma cell neoplasm
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Gammopathy
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Multiple myeloma (MM) is a malignant proliferation of plasma cells with multiple foci. Plasmacytoma is a solitary plasma cell neoplasm involving a single bone. The most commonly involved bone is vertebra. Jaw bones are rarely involved as a first bone as they have lesser hematopoietic marrow. A solitary plasmacytoma may progress to multiple myeloma within few months to year. We present a case of a swelling of mandible that on further investigations confirmed the diagnosis of multiple myeloma. We have discussed the course of treatment given and its prognosis. Keywords: multiple myeloma; plasmacytoma of jaw; bence jones Protein; abnormal plasma cells; CD138.
Plasma cell neoplasm
Plasma Cell Myeloma
Mandible (arthropod mouthpart)
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Myeloma protein
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