J Korean Med Sci.  2007 Aug;22(4):754-757. 10.3346/jkms.2007.22.4.754.

Solitary Extramedullary Plasmacytoma of the Liver without Systemic Monoclonal Gammopathy

• Lee JY
• Won JH
• Kim HJ
• Bae SB
• Kim CK
• Kim JH
• Lee NS
• Lee KT
• Park SK
• Jin SY
• Hong DS
• Park HS

• KMID: 1127101
• DOI: http://doi.org/10.3346/jkms.2007.22.4.754

Abstract

Extramedullary plasmacytoma of the liver is a very rare tumor. Although a few cases of extramedullary plasmacytoma of the liver have been reported, we could not find any report on truly localized extramedullary plasmacytoma of the liver in the literature. The patient was a 63-yr-old man who exhibited a solitary liver mass on dynamic computed tomography and magnetic resonance imaging. Histologically, the tumor was composed of mature plasma cells with mild atypia. Immunohistochemistry demonstrated monoclonal IgG and Kappa light chain expression. Bone marrow examination revealed no abnormalities. There was no evidence of a monoclonal protein in the serum and urine, lytic bone lesions, anemia, renal insufficiency, and hypercalcemia. The patient was treated with 5,000 cGy of radiotherapy, and the tumor disappeared 6 months after treatment.

Keyword

Plasmacytoma; Liver; Monoclonal Gammopathies; Radiotherapy

MeSH Terms

Humans
Immunoglobulin G/analysis
Immunoglobulin kappa-Chains/analysis
Immunohistochemistry
Liver Neoplasms/immunology/*pathology/radiotherapy
Magnetic Resonance Imaging
Male
Middle Aged
Monoclonal Gammopathies, Benign/immunology/pathology
Plasmacytoma/immunology/*pathology/radiotherapy
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 On contrast-enhanced computed tomography, the arterial phase image (A) shows a 2×2 cm-sized well enhanced mass in segment VI of the liver. This mass shows hypodensity on the portal venous phase (B). On magnetic resomance imaging, the T1-weighted image (C) shows a low signal intensity mass in segment VI. This mass shows high signal intensity in a T2-weighted image (D).

• 

  Fig. 2 The liver shows diffuse solid proliferation of monotonous small round to ovoid cells (A: H&E, ×100). They have eccentric cytoplasm and round nuclei with peripheral condensation of chromatin (B: H&E, ×400). Immunohistochemical stains of the hepatic mass exhibit monoclonality for IgG heavy chain (C: ABC, ×200) and kappa light chain (D: ABC, ×200).

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  Fig. 3 Follow-up contrast-enhanced CT after six months shows treatment response of the hepatic mass.

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