George Sara Mathew, Aljufairi Eman Ali, Chandran Nisha, Almahari Sayed Ali Isa
Department of Pathology, Salmaniya Medical Center, P.O. Box 12, Manama, Bahrain.
Case Rep Pathol. 2017;2017:4846018. doi: 10.1155/2017/4846018. Epub 2017 Apr 19.
Multiple myeloma is a neoplastic proliferation of monoclonal plasma cells. Although it is usually restricted to the bone marrow, extraskeletal spread in the form of localised extramedullary collections of malignant plasma cells (plasmacytomas) can occur. However, gastrointestinal tract involvement in multiple myeloma is rare and overt gastrointestinal bleeding from plasmacytoma is uncommon. We report a case of colonic plasmacytoma which presented with bleeding per rectum and was initially misdiagnosed as colonic neuroendocrine carcinoma. Later the patient presented with recurrence of the colonic mass along with multiple lytic bone lesions. The diagnosis of colonic plasmacytoma with progression into multiple myeloma was given. We also discuss here the diagnostic difficulty of plasma cell neoplasms in small biopsies of the colon.
多发性骨髓瘤是单克隆浆细胞的肿瘤性增殖。虽然它通常局限于骨髓，但也可能以恶性浆细胞的局限性髓外聚集（浆细胞瘤）形式发生骨骼外扩散。然而，多发性骨髓瘤累及胃肠道较为罕见，浆细胞瘤引起的明显胃肠道出血并不常见。我们报告一例结肠浆细胞瘤，该患者表现为直肠出血，最初被误诊为结肠神经内分泌癌。后来患者结肠肿物复发并伴有多处溶骨性骨病变。最终诊断为结肠浆细胞瘤进展为多发性骨髓瘤。我们还在此讨论了结肠小活检中浆细胞肿瘤的诊断困难。
