Korean J Radiol.  2007 Jun;8(3):246-248. 10.3348/kjr.2007.8.3.246.

Extramedullary Plasmacytoma Involving the Bilateral Adrenal Glands on MR Imaging

• Li Y
• Guo YK
• Yang ZG
• Ma ES
• Min PQ

• KMID: 1779442
• DOI: http://doi.org/10.3348/kjr.2007.8.3.246

Abstract

We report here on a 64-year-old woman with extramedullary plasmacytoma involving the bilateral adrenal glands. Primary adrenal extramedullary plasmacytoma is extremely rare and only three cases of extramedullary plasmacytoma in the unilateral adrenal gland have currently been reported on. This case is of interest in that the bilateral adrenals were involved. In this article, we present the MRI findings and we briefly review the relevant literature.

Keyword

Adrenal neoplasm; Extramedullary plasmacytoma; Magnetic resonance (MR)

MeSH Terms

Adrenal Gland Neoplasms/*diagnosis/surgery
Back Pain/etiology
Female
Humans
Kidney/pathology
*Magnetic Resonance Imaging
Middle Aged
Neoplasm Invasiveness
Plasmacytoma/*diagnosis/surgery
Vena Cava, Inferior/pathology

Figure

• 

  Fig. 1 Abdominal MRI demonstrates that the masses in the bilateral adrenal glands are homogeneous hypointense to the liver (black arrow) on the axial T1-weighted spin echo image (A) and hyperintense (white arrow) on the axial T2-weight spin echo image (B). The mass in the right adrenal region has invaded the inferior vein cava (A, B) and upper polar of the right kidney (white arrow) on the coronal T1-weighted spin echo image (C).

• 

  Fig. 2 A. Photomicrography of the histology specimen shows the tumor consists of poorly-differentiated plasma cells with large and hyperchromatic nuclei (Haematoxylin & Eosin, × 300). B. Immunohistochemical staining of the resected masses is positive for the monoclonality of IgG-lambda (Immunohistochemical staining, × 200).

Reference

1. Fernandez LA, Couban S, Sy R, Miller R. An unusual presentation of extramedullary plasmacytoma occurring sequentially in the testis, subcutaneous tissue, and heart. Am J Hematol. 2001. 67:194–196.

2. Kondo M, Hashimoto S, Inuyama Y, Okamoto R, Yamada F. Extramedullary plasmacytoma of the sinonasal cavities: CT evaluation. J Comput Assist Tomogr. 1986. 10:841–844.

3. Kahara T, Nagai Y, Yamashita H, Nohara E, Kobayashi K, Takamura T. Extramedullary plasmacytoma in the adrenal incidentaloma. Clin Endocrinol (Oxf). 2001. 55:267–270.

4. Rogers CG, Pinto PA, Weir EG. Extraosseous (extramedullary) plasmacytoma of the adrenal gland. Arch Pathol Lab Med. 2004. 128:e86–e88.

5. Fujikata S, Tanji N, Aoki K, Ohoka H, Hojo N, Yokoyama M. Extramedullary plasmacytoma arising from an adrenal gland. Urology. 2002. 60:514.

6. Kawashima A, Sandler CM, Fishman EK, Charnsangavej C, Yasumori K, Honda H, et al. Spectrum of CT findings in nonmalignant disease of the adrenal gland. Radiographics. 1998. 18:393–412.