Ashly Shino P, Thomas Anu C, Vadakkedam Sajeev S
Department of Neurosurgery, Indo American Hospital, Vaikom, Kerala, India.
Asian J Neurosurg. 2021 Dec 18;16(4):841-845. doi: 10.4103/ajns.AJNS_116_21. eCollection 2021 Oct-Dec.
Lympho plasmacytoma is distinct type of diffuse large B cell lymphoma predominantly seen in HIV-positive patients. The diagnosis of lympho plasmacytoma could be a challenge due to its overlapping characterizes with those of myeloma and lymphoma. We report a case of a 50-year-old man who initially presented with a painful solitary destructive lesion at the second lumbar vertebra. Clinico-pathological findings were consistent with a solitary plasmacytoma, and he was treated with definitive radiotherapy. Eight months after completing radiotherapy, he was found to have similar lesions at D4 vertebral body, multiple ribs, and pelvis. Subsequent biopsy confirmed lympho plasmacytoma. Because of its rarity and heterogeneous presentations, lympho plasmacytoma could easily be overlooked clinically and pathologically in immunocompetent patients. The diagnosis of lympho plasmacytoma should be considered when there is coexpression of myeloma and lymphoma immune markers.
淋巴浆细胞瘤是一种独特类型的弥漫性大B细胞淋巴瘤,主要见于HIV阳性患者。由于其与骨髓瘤和淋巴瘤的特征重叠,淋巴浆细胞瘤的诊断可能具有挑战性。我们报告一例50岁男性,最初表现为第二腰椎处疼痛性孤立性破坏性病变。临床病理结果与孤立性浆细胞瘤一致,他接受了根治性放疗。放疗结束8个月后,发现他在第4椎体、多根肋骨和骨盆处有类似病变。随后的活检证实为淋巴浆细胞瘤。由于其罕见性和表现的异质性,在免疫功能正常的患者中,淋巴浆细胞瘤在临床和病理上很容易被忽视。当存在骨髓瘤和淋巴瘤免疫标志物共表达时,应考虑淋巴浆细胞瘤的诊断。