Diaconescu Daniela, Iordan Iuliana, Dumitru Ion, Ilinescu Ana-Maria, Soare Delia, Ene Georgiana, Bumbea Horia
Hematology and Methodology of Scientific Research, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Bone Marrow Transplant Clinical Department, Emergency University Hospital, Bucharest, Romania.
Maedica (Bucur). 2025 Jun;20(2):422-427. doi: 10.26574/maedica.2025.20.2.422.
Multiple myeloma is a hematological malignancy mostly diagnosed in the elderly. It is characterized by a chronic evolution with alternating periods of remission and relapses. Plasmacytoma, a tumor comprised of monoclonal plasma cells, is a typical finding in multiple myeloma patients, being more frequently observed during relapses. The most involved sites are bones, kidneys, liver, skin, ear, nose and throat. Extramedullary lung plasmacytomas are a rare presentation, with an incidence of well under 5% of all plasmacytomas. The clinical manifestations are heterogeneous and depend on the affected site. Differentiating plasmacytoma from other pathologies can be challenging, with the diagnosis being established via tumor biopsy. The presence of plasmacytoma is associated with poor prognosis and is a marker of rapid disease progression. We report the case of a 63-year-old patient diagnosed with IgA lambda multiple myeloma, stage IIIB Salmon-Durie complicated by lung plasmacytoma identified in the setting of relapse. Despite undergoing treatment, the disease exhibited an aggressive course, rapidly progressive towards death. The case underlines the rarity of pulmonary plasmacytoma and the diagnostic challenges.
多发性骨髓瘤是一种主要在老年人中诊断出的血液系统恶性肿瘤。其特征是呈慢性病程，缓解期和复发期交替出现。浆细胞瘤是一种由单克隆浆细胞组成的肿瘤，是多发性骨髓瘤患者的典型表现，在复发期间更常被观察到。最常受累的部位是骨骼、肾脏、肝脏、皮肤、耳朵、鼻子和喉咙。髓外肺浆细胞瘤是一种罕见的表现，在所有浆细胞瘤中的发病率远低于5%。临床表现多种多样，取决于受累部位。将浆细胞瘤与其他病理情况区分开来可能具有挑战性，诊断需通过肿瘤活检来确定。浆细胞瘤的存在与预后不良相关，是疾病快速进展的一个标志。我们报告了一例63岁患者，诊断为IgA λ型多发性骨髓瘤，ⅢB期Salmon-Durie，在复发时并发肺浆细胞瘤。尽管接受了治疗，疾病仍呈侵袭性病程，迅速进展直至死亡。该病例凸显了肺浆细胞瘤的罕见性以及诊断挑战。
