Primary pulmonary plasmacytoma.

Abstract

A patient was diagnosed with an extramedullary plasmacytoma of the lung after complete resection of the mass at thoracotomy. Immunoperoxidase staining of the mass revealed monoclonal lambda chains. Screening for multiple myeloma identified a small amount of M-protein in the blood, but no other evidence of multiple myeloma was found. A literature search was conducted to determine the prognosis and the best way to manage the patient. Nineteen cases of primary pulmonary plasmacytoma were found in the literature. The age range was 3-79 years. Most of these cases were diagnosed at thoracotomy and treated by surgical excision. Immunohistochemical evaluation of the lesion is essential for diagnosis but was done in only three cases. Surgery and radiation therapy seem to be equally effective forms of treatment. The role of adjuvant chemotherapy is unknown. Local recurrences are rare. Follow-up data were inadequate to determine disease-free survival, progression to multiple myeloma, and overall survival in primary pulmonary plasmacytoma. Close follow-up is needed to detect progression.