Clin Endosc.  2014 Nov;47(6):564-567. 10.5946/ce.2014.47.6.564.

Successful Treatment of a Gastric Plasmacytoma Using a Combination of Endoscopic Submucosal Dissection and Oral Thalidomide

• Park SY
• Moon HS
• Seong JK
• Jeong HY
• Yoon BY
• Hwang SW
• Song KS

• KMID: 2134496
• DOI: http://doi.org/10.5946/ce.2014.47.6.564

Abstract

We report a rare case of a gastric plasmacytoma treated with endoscopic resection and oral thalidomide therapy. A 70-year-old man was admitted to our hospital with indigestion. He had no specific medical history and unremarkable laboratory results. Gastroendoscopic findings revealed a focal, erythematous, flat elevated lesion in the anterior wall of the stomach antrum. A biopsy revealed atypical lymphocytes. Endoscopic submucosal dissection (ESD) with an insulation-tipped knife was performed 45 days after diagnosis. Radiological and hematological evaluations, including a bone marrow biopsy, were performed and showed no involvement of other organs. The patient was diagnosed with extramedullary gastric plasmacytoma. Follow-up gastroendoscopy was performed three times during a 2-year period and showed nonspecific ESD scarring. The patient's condition was found to be stable.

Keyword

Endoscopic submucosal dissection; Gastric plasmacytoma; Extramedullary plasmacytomas

MeSH Terms

Aged
Biopsy
Bone Marrow
Cicatrix
Diagnosis
Dyspepsia
Follow-Up Studies
Humans
Lymphocytes
Plasmacytoma*
Stomach
Thalidomide*
Thalidomide

Figure

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  Fig. 1 (A, B) Endoscopy showed a focal, erythematous, flat elevated lesion in the anterior wall of the stomach antrum.

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  Fig. 2 (A) The lesion was resected using endoscopic submucosal dissection with an insulation-tipped knife. (B) The resected tumor was 40×35 mm in size.

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  Fig. 3 (A) Numerous plasma cells were observed to infiltrate the gastric mucosa. Some of these cells contained atypical hyperchromatic nuclei (H&E stain, ×100). (B) The neoplastic cells were positive for CD138 (immunostaining, ×400). (C) The neoplastic cells were also positive for κ light chain (immunostaining, ×400).

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  Fig. 4 (A) Gastroendoscopic findings showed nonspecific endoscopic submucosal dissection (ESD) scarring 1 year after ESD. (B) Gastroendoscopic findings showed no interval change in ESD scarring 2 years after ESD.

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