Primary Extramedullary Plasmacytoma of Maxillary Sinus

ABSTRACT A rare case of extramedullary plasmacytoma of maxillary sinus in a 58-year-old man presenting with right-sided nasal obstruction and intermittent blood tinged nasal crusting. Nasal endoscopy revealed that a dark red colored mass arising from the lateral wall of nose. A biopsy specimen was diagnosed as plasmacytoma (Kappa light chain type). Serum and urine electrophoresis failed to detect any myeloma component or Bence-Jones protein. All other screening tests to rule out multiple myeloma were negative. These findings confirmed the diagnosis of extramedullary plasmacytoma. The mass was completely excised by lateral rhinotomy approach. No recurrence has been noted at the end of 6 months follow-up. How to cite this article Ray CS, Mishra A, Khatua RK, Baliarsingh P. Primary Extramedullary Plasmacytoma of Maxillary Sinus. Clin Rhinol An Int J 2013;6(1):51-53.

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Extramedullar Plasmacytoma Arising from the Nasal Septum

Ear Nose & Throat Journal ◽

10.1177/014556130508401114 ◽

2005 ◽

Vol 84 (11) ◽

pp. 720-722 ◽

Cited By ~ 4

Author(s):

Byoung J. Baek ◽

Seong W. Kim ◽

Hoon Park ◽

Jin K. Park ◽

Kyung Y. Han ◽

...

Keyword(s):

Nasal Septum ◽

Biopsy Specimen ◽

Extramedullary Plasmacytoma ◽

Screening Tests ◽

Bence Jones Protein ◽

Light Chain Type ◽

History Of ◽

Chain Type ◽

Rule Out

We report a rare case of extramedullary plasmacytoma of the nasal septum in a 65-year-old woman. She presented with a 2-month history of left-sided nasal obstruction and intermittent blood-tinged nasal crusting. Nasal endoscopy revealed that a dark-red mass had arisen from the nasal septum; no evidence of invasion to adjacent tissues was seen. A biopsy specimen was diagnosed as a plasmacytoma (kappa light chain—type). Serum and urine electrophoresis failed to detect any myeloma component or Bence Jones protein. All other screening tests to rule out multiple myeloma were negative. These findings confirmed the diagnosis of extramedullary plasmacytoma. The mass was completely removed via an endoscopic approach. No recurrence was noted at the 2-year follow-up.

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Nasal septum extramedullary plasmacytoma

Vojnosanitetski pregled ◽

10.2298/vsp1302221b ◽

2013 ◽

Vol 70 (2) ◽

pp. 221-224 ◽

Cited By ~ 2

Author(s):

Branislav Belic ◽

Slobodanka Mitrovic ◽

Snezana Arsenijevic ◽

Ljiljana Erdevicki ◽

Jasmina Stojanovic ◽

...

Keyword(s):

Nasal Cavity ◽

Nasal Septum ◽

Plasma Cells ◽

Malignant Tumors ◽

Combined Therapy ◽

Extramedullary Plasmacytoma ◽

Screening Tests ◽

The Right ◽

Nose And Throat

Introduction. Plasmacytomas are malignant tumors characterized by abnormal monoclonal proliferation of plasma cells. They originate in either bone - solitary osseous plasmacytoma, or in soft tissue - extramedullary plasmacytoma (EMP). EMP represents less than 1% of all head and neck malignancies. Case report. We presented a case of EMP of the nasal septum in a 44-year-old male who had progressive difficulty in breathing through the nose and frequent heavy epistaxis on the right side. Nasal endoscopy showed dark red, soft, polypoid tumor in the last third of the right nasal cavity arising from the nasal septum. The biopsy showed that it was plasmacytoma. Bence Jones protein in the urine, serum electrophoresis, bone marrow biopsy, skeletal survey and other screening tests failed to detect multiple myeloma. This confirmed the diagnosis of EMP. The mass was completely removed via an endoscopic approach, and then, 4 week later, radiotherapy was conducted with a radiation dose of 50 Gray. No recurrence was noted in a 3-year follow- up period. Conclusion. EMP of the nasal cavity, being rare and having long natural history, represents a diagnostic and therapeutic challenge for any ear, nose and throat surgeon. Depending on the resectability of the lesion, a combined therapy is the accepted treatment.

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Bilateral antrochoanal polyps: a case report

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00090-0 ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Kaoutar cherrabi ◽

Nabil Touihem ◽

Ismail Nakkabi ◽

Karim Nadour

Keyword(s):

Maxillary Sinus ◽

Clinical Presentation ◽

Clinical Signs ◽

Lateral Wall ◽

Uncinate Process ◽

Sinus Surgery ◽

Case Presentation ◽

Nasal Vestibule ◽

Excellent Outcome

Abstract Background Antrochoanal or Killian polyp is a rare polyp of the maxillary sinus in adults. It is generally unilateral, implanted on the lateral wall of the maxillary sinus upon the uncinate process. Bilateral cases are very rare; only 14 cases have been cited from 1980 to 2020. Case presentation Our patient presented with a complete bilateral nasal obstruction, this symptom persisted for more than 10 years, with a perceived prolapse in his throat in the last 4 months. Anterior rhinoscopy showed a polyp that took up the totality of his nasal vestibule. Posterior rhinoscopy showed a polyp bulging behind the uvula. The challenge in this case is related to diagnosis decision; conditions with the same clinical presentation are several. Diagnosis was established through the clinical, radiological, and endoscopic aspects, and confirmed by histological findings. Management was obtained through functional endoscopic sinus surgery; no recurrence was noted in the 12-month follow-up, and clinical signs had completely subsided. Conclusion Diagnosis in bilateral forms of Killian polyp is perplexing; however, its management is generally simple, with excellent outcome. We report the case of the 15th patient along with a systematic literature review discussing bilateral Killian polyps, illustrated by a rare case of enormous bilateral antrochoanal polyps.

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The combined low-dose dexamethasone suppression corticotropin-releasing hormone test as a tool to rule out Cushing's syndrome

Acta Endocrinologica ◽

10.1530/eje-08-0402 ◽

2008 ◽

Vol 159 (5) ◽

pp. 569-576 ◽

Cited By ~ 13

Author(s):

Giuseppe Reimondo ◽

Silvia Bovio ◽

Barbara Allasino ◽

Silvia De Francia ◽

Barbara Zaggia ◽

...

Keyword(s):

Cushing’S Syndrome ◽

Low Dose ◽

Cushing's Syndrome ◽

The Other ◽

Screening Tests ◽

Corticotropin Releasing Hormone ◽

Releasing Hormone ◽

Dexamethasone Suppression ◽

Rule Out

ObjectiveIt remains to be evaluated whether the combined low-dose dexamethasone suppression corticotropin-releasing hormone test (LDDST-CRH test) may add to the diagnostic approach of patients suspected to have Cushing's syndrome (CS). The aim of the present study was to evaluate whether the LDDST-CRH test may have a place in the diagnostic strategy of CS.DesignProspective evaluation of a consecutive series of patients with suspected CS from 2004 to 2006.MethodsAll the subjects underwent the same screening protocol including 1 mg dexamethasone suppression test, 24-h urinary free cortisol (UFC), and midnight serum cortisol, followed by the LDDST-CRH test whose results were not used to establish a definitive diagnosis. Plasma dexamethasone concentration was measured 2 h after the last dose of dexamethasone. Patients qualified for CS when at least two screening tests were positive.ResultsSixteen patients had CS while in the remaining 15 subjects CS was excluded. Even if not statistically significant, the sensitivity and the negative predictive value of the cortisol 15 min after CRH were better than the other tests; on the other hand, the test specificity was lower. All of the patients classified as indeterminate were correctly diagnosed by the LDDST-CRH test. Nevertheless, the repeated assessment of the screening tests and the active follow-up gave the same correct results. In all of the patients misclassified by the LDDST-CRH test, the plasma dexamethasone concentrations were in the normal range.ConclusionsBased on our findings, we suggest that the LDDST-CRH test may still find a place as a rule-out procedure in patients who present with indeterminate results after screening and may be unavailable to repeat testing during follow-up.

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Solitary Extramedullary Plasmacytoma of the Oropharynx: A Rare Location

Ear Nose & Throat Journal ◽

10.1177/014556139307201112 ◽

1993 ◽

Vol 72 (11) ◽

pp. 743-745 ◽

Cited By ~ 2

Author(s):

John Segas ◽

Haralambos Skoulakis ◽

George Katrinakis ◽

Maria Tzardis

Keyword(s):

Excisional Biopsy ◽

Extramedullary Plasmacytoma ◽

Light Chains ◽

Left Posterior ◽

Long Term Follow Up ◽

Rare Location ◽

Solitary Extramedullary Plasmacytoma ◽

Rule Out

We describe a case of solitary extramedullary plasmacytoma of the oropharynx growing on the left posterior tonsillar pillar. The clinical picture was difficulty in swallowing caused from the partial obstruction of the area and bleeding from the ulcerated tumor. Lambda light chains were identified on immunohistochemical staining but they were not detected in either serum or urine (non-secreting tumor). Excisional biopsy followed by radiation therapy were used for treatment. Long-term follow up for several years is necessary in order to rule out evolution to multiple myeloma.

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Extramedullary Plasmacytoma of the Nasopharynx: A Rare Tumour with 7-Year Follow Up

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v26i1.599 ◽

2011 ◽

Vol 26 (1) ◽

pp. 27-30

Author(s):

Mawaddah Azman ◽

Balwant Singh Gendeh ◽

Siti Aishah Mat Ali

Keyword(s):

Multiple Myeloma ◽

Cervical Lymphadenopathy ◽

Neck Region ◽

Good Prognosis ◽

Extramedullary Plasmacytoma ◽

Screening Tests ◽

Rare Tumour ◽

Long Term Follow Up ◽

The Right

Objective: To report a case of extramedullary plasmacytoma, a rare localized tumour involving the head and neck region in a 56-year -old gentleman. Methods: Design: Case Report Setting: Tertiary University Referral Center Patient: One Result: The patient presented with a 5-month history of right-sided nasal obstruction and intermittent epistaxis in 2003. Nasal endoscopy revealed a friable, dark red mass arising from the roof of the nasopharynx, occluding the right choana. No invasion of adjacent tissues or cervical lymphadenopathy was evident. A biopsy of the mass was diagnosed as plasmacytoma. Serum and urine electrophoresis failed to detect any monoclonal bands. All other screening tests to rule out multiple myeloma were negative. These findings confirmed the diagnosis of extramedullary plasmacytoma. He recieved radiotherapy to the nasopharynx of 50 Gy for a total of 23 fractions. No recurrence was noted at 7-year follow-up. Conclusion: Extramedullary plasmacytoma of the nasopharynx represents a tumour with good prognosis but requires long term follow up in anticipation of local recurrence and progression to Multiple Myeloma. Keywords: extramedullary, plasmacytoma, nasopharynx

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D-Dimer Determination to Exclude Pulmonary Embolism: a Two-Step Approach Using Latex Assay as a Screening Tool

Thrombosis and Haemostasis ◽

10.1055/s-0038-1648817 ◽

1994 ◽

Vol 72 (01) ◽

pp. 089-091 ◽

Cited By ~ 21

Author(s):

P de Moerloose ◽

Ph Minazio ◽

G Reber ◽

A Perrier ◽

H Bounameaux

Keyword(s):

Pulmonary Embolism ◽

Screening Tool ◽

Screening Tests ◽

Enzyme Linked Immunosorbent Assay ◽

Elisa Assay ◽

Elisa Technique ◽

Diagnostic Step ◽

D Dimer ◽

Rule Out ◽

Latex Test

SummaryD-dimer (DD), when measured by a quantitative enzyme-linked immunosorbent assay (ELISA), is a valuable test to exclude venous thromboembolism (VTE). However, DD ELISA technique is not appropriate for emergency use and the available agglutination latex assays are not sensitive enough to be used as an alternative to rule out the diagnosis of VTE. Latex assays could still be used as screening tests. We tested this hypothesis by comparing DD levels measured by ELISA and latex assays in 334 patients suspected of pulmonary embolism. All but one patient with a positive (DD ≥500 ng/ml) latex assay had DD levels higher than 500 ng/ml with the ELISA assay. Accordingly, ELISA technique could be restricted to patients with a negative result in latex assay. This two-step approach would have spared about 50% of ELISA in our cohort. In conclusion, our data indicate that a latex test can be used as a first diagnostic step to rule out pulmonary embolism provided a negative result is confirmed by ELISA and the performance of the latex assay used has been assessed properly.

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The Immunological Characterization of Human Antibodies to Factor VIII Isolated by Immuno-Affinity Chromatography

Thrombosis and Haemostasis ◽

10.1055/s-0038-1650129 ◽

1981 ◽

Vol 45 (01) ◽

pp. 060-064 ◽

Cited By ~ 10

Author(s):

M L Kavanagh ◽

C N Wood ◽

J F Davidson

Keyword(s):

Factor Viii ◽

Affinity Chromatography ◽

Gel Filtration ◽

Immunological Characterization ◽

Human Antibodies ◽

Heavy Chains ◽

Light Chain Type ◽

Antibody Preparations ◽

Chain Type

SummaryNine human antibodies to factor VIII were isolated from haemophilic plasmas by affinity chromatography and gel filtration and six were subsequently subjected to immunological characterization. Three partially purified preparations were similarly characterized. Eight of the antibodies were characterized as being exclusively IgG and one preparation was found to contain IgM. Seven of the antibodies contained only a single light chain type, four being of type lambda and three of type kappa. Two antibody preparations contained both kappa and lambda light chains. In four of the preparations, only a single heavy chain sub-class could be demonstrated, three of IgG3 and one of IgG4. Of the remainder, three were a mixture of IgG3 and IgG4 sub-classes and one contained both IgG2 and IgG4. IgG sub-classification could not be achieved with the IgM-containing preparation. These results demonstrate a restricted heterogeneity of light and heavy chains in human antibodies to factor VIII.

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