J Korean Ophthalmol Soc.  2015 Mar;56(3):427-431. 10.3341/jkos.2015.56.3.427.

A Case of Extramedullary Plasmacytoma in the Lacrimal Excretory System

• Lee SJ
• Choi CW
• Kim SD

• KMID: 2339050
• DOI: http://doi.org/10.3341/jkos.2015.56.3.427

Abstract

PURPOSE
To report a case of extramedullary plasmacytoma in the lacrimal excretory system.
CASE SUMMARY
A 56-year-old female patient suffering from chronic epiphora for 1 year and having a non-tender, fixed palpable mass in the medial canthus of the eyelid visited the outpatient clinic. Orbital CT showed the non-enhancing mass was located along the right lacrimal sac and nasolacrimal duct and protruded into the nasal cavity. Biopsy was performed at the Otolaryngology Department. Based on histopathological examination, the mass was diagnosed as extramedullary plasmacytoma and the patient was treated with a total dose of 4500 cGy radiation (25 times in 1 month). After the 28-month follow-up period, the mass was not observed on Sinus CT and there was no recurrence. Additionally, no specific lesion was found during nasal endoscopy.
CONCLUSIONS
We report a case of extramedullary plasmacytoma in the lacrimal excretory system successfully treated by radiation therapy.

Keyword

Extramedullary plasmacytoma; Lacrimal excretory system; Radiation therapy

MeSH Terms

Ambulatory Care Facilities
Biopsy
Endoscopy
Eyelids
Female
Follow-Up Studies
Humans
Lacrimal Apparatus Diseases
Middle Aged
Nasal Cavity
Nasolacrimal Duct
Orbit
Otolaryngology
Plasmacytoma*
Recurrence

Figure

• 

  Figure 1. Orbital MRI showing a homogenous mass in the right lacrimal excretory system. (A) Coronal view CT scan. (B) Axial view CT scan.

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  Figure 2. (A) Monotonous cells having eccentrically located nu-clei, which are characteristic of plasma cell tumors. (Hematoxylin ad eosin staining ×400). (B) Tumor cells showing cytoplasmic k– light chain positivity (×400). (C) Tumor cells showing cytoplasmic λ– light chain negativity (×400).

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  Figure 3. Coronal (A) and axial (B) view of the orbit CT scan after treatment. There is no mass in the right lacrimal excretory system.

Reference

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