Çelebi İrfan, Bozkurt Gülpembe, Polat Nedim
Department of Radiology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey.
Department of Otolaryngology, Acıbadem University Faculty of Medicine, Istanbul, Turkey.
BMC Med Imaging. 2018 Jun 18;18(1):19. doi: 10.1186/s12880-018-0261-9.
Malignant plasma cell proliferation may present as a disseminated disease (multiple myeloma), a solitary plasmacytoma of bone, or an extramedullary plasmacytoma of soft tissue. The latter plasmacytomas represent approximately 3% of all plasma cell proliferations, and 80% develop in the head-and-neck region. The unexpected clinical presentation of such masses may be present.
Here, we report a rare case of primary tonsillar plasmacytoma in a 42-year-old female. The patient presented with asymmetric tonsillar hypertrophy that was resistant to antibiotherapy. Upon further workup, we found no evidence of multiple myeloma or light-chain disease. The patient underwent surgery and, at the last follow-up, exhibited no evidence of such disease.
In adults presenting with asymptomatic tonsillar enlargement, the possibility of submucosal masses should be considered, thus encouraging the radiologist to evaluate crypts within the palatine tonsil on a postcontrast MRI, besides enlargement and signal change.
恶性浆细胞增殖可表现为播散性疾病（多发性骨髓瘤）、骨孤立性浆细胞瘤或软组织髓外浆细胞瘤。后者约占所有浆细胞增殖性疾病的3%，80%发生于头颈部区域。此类肿块可能有意外的临床表现。
在此，我们报告一例42岁女性原发性扁桃体浆细胞瘤的罕见病例。患者表现为不对称性扁桃体肥大，对抗生素治疗无效。进一步检查后，我们未发现多发性骨髓瘤或轻链病的证据。患者接受了手术，在最后一次随访时，未发现此类疾病的迹象。
对于出现无症状扁桃体肿大的成年人，应考虑黏膜下肿块的可能性，这促使放射科医生在增强磁共振成像（MRI）上除了评估扁桃体的大小和信号变化外，还要评估腭扁桃体隐窝。
