Solitary plasmacytoma

3 Interesting Facts of Solitary plasmacytoma

  1. A solitary plasmacytoma is a single tumor composed of monoclonal plasma cells
    • A solitary plasmacytoma of bone is a plasma cell tumor located only in bone, without other clinical features (ie, myeloma-defining events) of multiple myeloma
    • However, the plasmacytoma itself contains clonal plasma cells that are histologically similar to those that occur in multiple myeloma
  2. Like multiple myeloma, a solitary plasmacytoma presents with bony pain or with a pathologic fracture of the affected bone
    • Most common sites are the vertebrae, pelvis, and ribs
  3. To define the entity of solitary plasmacytoma, perform additional imaging (with whole body MRI or fludeoxyglucose F 18 PET with CT) and diagnostic testing as follows:
    • All 4 criteria must be met to classify a lesion as a solitary plasmacytoma 
      • Biopsy-proven solitary lesion of bone or soft tissue with evidence of clonal plasma cells
      • Normal bone marrow with no evidence of clonal plasma cells
      • Normal results on skeletal survey and MRI of spine and pelvis (except for the primary solitary lesion)
      • No evidence of end-organ damage such as hypercalcemia, renal insufficiency, anemia, or bone lesions that can be attributed to a lymphoproliferative disorder

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