Lymphnode Involvement in Plasmacytoma

A case of plasmacytoma of the spine with multiple sites of involvement at presentation is reported. The sites involved were T4, T5, T9 levels and the jugular foramen. The patient had no evidence of bone marrow involvement or paraprotein either in the serum or urine. Resections of the tumour from T4 and T5 levels was performed, followed by radiation therapy. The patient developed a recurrence seven and half years after the initial presentation. The recurrence occurred at the right clavicle and in the soft tissue around it. This was followed by multiple recurrences at the same site with involvement of the supraclavicular lymphnodes inspite of aggressive chemotherapy, radiation therapy and autologous stem cell transplant. Fine Needle Aspiration cytology and histology showed a typical plasma cell neoplasm with characterstic nuclear features, immunohistochemistry was compatible with a plasmacytoma. Bahrain Med Bull 2005; 27(4): A plasmacytoma is a discrete, solitary mass of neoplastic monoclonal plasma cells found in either bone marrow or a soft tissue site. These neoplasms can occur as extramedullary solitary plasmacytomas (primary true plasmacytoma of the mucosa with or without affected lymph nodes) and it can be an extramedullary manifestation of multiple myeloma, multiple myeloma, and plasmablastic sarcoma1. Plasmacytoma involving lymphnodes is rare. This can occur as a manifestation of regional lymph node involvement in extramedullary plasmacytoma or even more rarely as a primary extramedullary plasmacytoma occurring in lymph node1. An unusual case of plasmacytoma of the spine is reported with involvement of the right supraclavicular lymph nodes. The fine needle aspiration cytology and histology are presented and discussed