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Diagnosis and management of extramedullary plasmacytoma in nasal cavity: Clinical experience and literature review

Nasal extramedullary plasmacytoma (EMP) is a rare plasma cell tumor that occurs in the soft tissue of the nasal cavity, and its imaging characteristics are still unclear. The purpose of this study was to investigate the clinical features, imaging findings, treatment, survival analysis, and prognosis...

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Autores principales: Hu, Hongyu, Hu, Xianwen, Hu, Guomei, Li, Dandan, Cai, Jiong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9839280/
https://www.ncbi.nlm.nih.gov/pubmed/36637932
http://dx.doi.org/10.1097/MD.0000000000032647
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author Hu, Hongyu
Hu, Xianwen
Hu, Guomei
Li, Dandan
Cai, Jiong
author_facet Hu, Hongyu
Hu, Xianwen
Hu, Guomei
Li, Dandan
Cai, Jiong
author_sort Hu, Hongyu
collection PubMed
description Nasal extramedullary plasmacytoma (EMP) is a rare plasma cell tumor that occurs in the soft tissue of the nasal cavity, and its imaging characteristics are still unclear. The purpose of this study was to investigate the clinical features, imaging findings, treatment, survival analysis, and prognosis of nasal EMP, and to provide a systematic review of the patients we treated and the published literature. A 45-year-old female patient who presented with epistaxis with nasal obstruction was recommended for magnetic resonance imaging to assess the nature of the lesion. On magnetic resonance imaging, abnormal signal shadow can be seen in the right nasal cavity. Diffusion weighted imaging showed signal of the lesion was significantly limited, presenting high signal, with a low apparent dispersion coefficient, and the lesion was significantly enhanced on contrast-enhanced scan. Combined with the clinical manifestations of the patient, who was initially considered to have a hemangioma. She underwent endoscopic nasal surgery under general anesthesia to remove the mass, and the final pathology confirmed it was EMP. However, the final pathology confirmed EMP. Five months later, the patient came to our hospital for follow-up and underwent fluorine-18-fluorodeoxyglucose/positron emission tomography/computed tomography scan, which showed no recurrence of the lesion and no transformation of multiple myeloma. The nasal EMP imaging findings were mostly soft tissue masses with uniform density or signal, which were significantly enhanced by enhancement scan, high signal on diffusion weighted imaging and low signal on apparent dispersion coefficient. Immunohistochemical staining for CD38, CD138, and CD79a was positive in most of the cases evaluated, while CD20 and CD10 were negative. The absence of dilated features, infiltrative features and the presence of significant contrast enhancement may be relatively specific imaging findings of nasal EMP. The prognosis of nasal EMP is good, and recurrence, metastasis, and transformation into multiple myeloma are rare. Because the lesions are sensitive to radiotherapy, surgical resection combined with radiotherapy is a more effective treatment.
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spelling pubmed-98392802023-01-17 Diagnosis and management of extramedullary plasmacytoma in nasal cavity: Clinical experience and literature review Hu, Hongyu Hu, Xianwen Hu, Guomei Li, Dandan Cai, Jiong Medicine (Baltimore) 5700 Nasal extramedullary plasmacytoma (EMP) is a rare plasma cell tumor that occurs in the soft tissue of the nasal cavity, and its imaging characteristics are still unclear. The purpose of this study was to investigate the clinical features, imaging findings, treatment, survival analysis, and prognosis of nasal EMP, and to provide a systematic review of the patients we treated and the published literature. A 45-year-old female patient who presented with epistaxis with nasal obstruction was recommended for magnetic resonance imaging to assess the nature of the lesion. On magnetic resonance imaging, abnormal signal shadow can be seen in the right nasal cavity. Diffusion weighted imaging showed signal of the lesion was significantly limited, presenting high signal, with a low apparent dispersion coefficient, and the lesion was significantly enhanced on contrast-enhanced scan. Combined with the clinical manifestations of the patient, who was initially considered to have a hemangioma. She underwent endoscopic nasal surgery under general anesthesia to remove the mass, and the final pathology confirmed it was EMP. However, the final pathology confirmed EMP. Five months later, the patient came to our hospital for follow-up and underwent fluorine-18-fluorodeoxyglucose/positron emission tomography/computed tomography scan, which showed no recurrence of the lesion and no transformation of multiple myeloma. The nasal EMP imaging findings were mostly soft tissue masses with uniform density or signal, which were significantly enhanced by enhancement scan, high signal on diffusion weighted imaging and low signal on apparent dispersion coefficient. Immunohistochemical staining for CD38, CD138, and CD79a was positive in most of the cases evaluated, while CD20 and CD10 were negative. The absence of dilated features, infiltrative features and the presence of significant contrast enhancement may be relatively specific imaging findings of nasal EMP. The prognosis of nasal EMP is good, and recurrence, metastasis, and transformation into multiple myeloma are rare. Because the lesions are sensitive to radiotherapy, surgical resection combined with radiotherapy is a more effective treatment. Lippincott Williams & Wilkins 2023-01-13 /pmc/articles/PMC9839280/ /pubmed/36637932 http://dx.doi.org/10.1097/MD.0000000000032647 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle 5700
Hu, Hongyu
Hu, Xianwen
Hu, Guomei
Li, Dandan
Cai, Jiong
Diagnosis and management of extramedullary plasmacytoma in nasal cavity: Clinical experience and literature review
title Diagnosis and management of extramedullary plasmacytoma in nasal cavity: Clinical experience and literature review
title_full Diagnosis and management of extramedullary plasmacytoma in nasal cavity: Clinical experience and literature review
title_fullStr Diagnosis and management of extramedullary plasmacytoma in nasal cavity: Clinical experience and literature review
title_full_unstemmed Diagnosis and management of extramedullary plasmacytoma in nasal cavity: Clinical experience and literature review
title_short Diagnosis and management of extramedullary plasmacytoma in nasal cavity: Clinical experience and literature review
title_sort diagnosis and management of extramedullary plasmacytoma in nasal cavity: clinical experience and literature review
topic 5700
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9839280/
https://www.ncbi.nlm.nih.gov/pubmed/36637932
http://dx.doi.org/10.1097/MD.0000000000032647
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