4.4 Article

Plasmacytoma and plasma cell myeloma affecting the jaws: A multi-institutional collaborative study

期刊

JOURNAL OF ORAL PATHOLOGY & MEDICINE
卷 50, 期 6, 页码 613-621

出版社

WILEY
DOI: 10.1111/jop.13213

关键词

mandible; multiple myeloma; oral cavity; plasma cell myeloma; plasmacytoma

资金

  1. Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES/Brazil) [001]
  2. Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq/Brazil) [305493/2018-3, 455644/2018-1]
  3. Sao Paulo State Research Foundation (FAPESP/Brazil) [17/14880-3]

向作者/读者索取更多资源

Plasma cell neoplasms in the jaws were studied in 52 cases, showing no sex predilection, usually accompanied by pain and paresthesia. Radiographically and microscopically, the lesions presented as osteolytic lesions with diffuse proliferation of neoplastic plasma cells.
Background Plasma cell neoplasms are characterized by the proliferation of a single clone of plasma cells with production of a monoclonal immunoglobulin. They can manifest as a single lesion (plasmacytoma) or as multiple lesions (multiple myeloma). Methods Paraffin-embedded tissue blocks of patients microscopically diagnosed with plasma cell neoplasms in the jaws were retrieved from five pathology files. Data including clinical, radiographic, microscopic and immunohistochemical findings, treatment employed and follow-up status were retrieved from the pathology reports. Results Fifty-two cases were retrieved (mean age: 59.4 years) without sex predilection. The mandible was the most affected site (67.3%), usually associated with pain and/or paresthesia (53.8%). Lesions in other bones besides the jaws were reported for 24 patients (46.2%). Radiographically, tumours usually presented as poorly defined osteolytic lesions with unilocular or multilocular images, while microscopy revealed diffuse proliferation of neoplastic plasma cells with nuclear displacement and abundant eosinophilic cytoplasm. Two cases were classified as anaplastic, and amyloid deposits were found in two other cases. Immunohistochemistry was positive for plasma cell markers and negative for CD20 and CD3, and monoclonality for kappa light chain predominated. The overall survival rate after 5 years of follow-up was 26.6%. Conclusion Plasma cell neoplasms are aggressive tumours with a poor prognosis and involvement of the jaws may be the first complaint of the patient. Thus, oral pathologists, head and neck surgeons and dentists should be aware of their clinical, radiographic and microscopic manifestations.

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