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Plasma cell neoplasm (see abstractor notes or non reportable list)
Plasma cell tumor
Plasmacytoma of bone
A type of cancer that begins in the plasma cells (white blood cells that produce antibodies). A plasmacytoma may turn into multiple myeloma. Clonal proliferation of plasma cells cytologically and immunophenotypically identical to those of plasma cell myeloma but manifesting as localized osseous growth. The most common primary sites are in the bones with the most active hematopoiesis, including vertebrae, ribs, skull, pelvis, femur, clavicle, and scapula. Plasmacytoma is a localized collection of monoclonal plasma cells. Diagnosed on basis of: single bone lesion with histology consistent with a plasma cell tumor; absence of a plasma cell infiltrate in random bone marrow biopsies; no evidence of other bone lesions by radiographic examination; absence of renal failure; no hypercalcemia; no anemia.
This is a localized tumor in the bone consisting of monoclonal plasma cells. Complete skeletal radiographs (preferably MRI) show no other lesions. There is no evidence of bone marrow plasmacytosis other than the solitary lesion. Vertebral lesions may be associated with symptomatic cord compression. The most common primary sites are the vertebrae, ribs, skull, pelvis, femur, clavicle, and scapula. Thoracic vertebrae are more commonly involved than cervical or lumbar. Patient presents with bone pain at the site of the lesion or with a pathological fracture. Soft tissue extension may produce a palpable mass. An M-protein is found in the serum or urine in 24-72% of patients. There is no anemia, hypercalcemia, or renal failure related to the plasmacytoma. Local control is achieved by radiotherapy. Plasma cells are usually easily recognizable in tissue specimens. Even when the diagnosis is apparent, determination of light chain type is suggested.
Plasma cell neoplasm was previously included as an alternate name for plasmacytoma. The phrase "plasma cell neoplasm" is an umbrella term used for many diseases, some of which are not reportable. If the only diagnosis is "plasma cell neoplasm," then do not report this case. If it is "plasma cell neoplasm" consistent with a plasmacytoma or multiple myeloma, then the case would be reportable.
Definitive Diagnostic Methods
Ig clonal rearrangements, complex karyotypes with multiple chromosomal gains/losses; also translocations, deletions, mutations