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Spine
Diagnosis
Neoplasms, Cysts, and Other Masses
Neoplasms
Extradural
Plasmacytoma
Plasmacytoma
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Solitary bone plasmacytoma (SBP), solitary myeloma, solitary plasma cell tumor

            • Definitions

              • Solitary monoclonal plasma cell tumor of bone or soft tissue without evidence of multiple myeloma (MM)
              • Diagnosis requires
                • Solitary lesion, biopsy showing plasma cells
                • Negative skeletal survey, negative MR spine, pelvis, proximal femora/humeri
                • Negative clonal cells in marrow aspirate
                • No anemia, hypercalcemia, or renal involvement suggesting systemic myeloma

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Nonvascular Interventions

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Wang Y et al: Solitary plasmacytoma of bone of the spine: results from surveillance, epidemiology, and end results (SEER) registry. Spine (Phila Pa 1976). 44(2):E117-25, 2019
                                                2. Caers J et al: Diagnosis, treatment, and response assessment in solitary plasmacytoma: updated recommendations from a European Expert Panel. J Hematol Oncol. 11(1):10, 2018
                                                3. Dimopoulos MA et al: Role of magnetic resonance imaging in the management of patients with multiple myeloma: a consensus statement. J Clin Oncol. 33(6):657-64, 2015
                                                4. Song IC et al: Diagnostic and prognostic implications of spine magnetic resonance imaging at diagnosis in patients with multiple myeloma. Cancer Res Treat. 47(3):465-72, 2014
                                                5. Yang JS et al: Rapid progression of solitary plasmacytoma to multiple myeloma in lumbar vertebra. J Korean Neurosurg Soc. 54(5):426-30, 2013
                                                6. Afonso PD et al: Solitary plasmacytoma of the spine: an unusual presentation. AJNR Am J Neuroradiol. 31(1):E5, 2010
                                                7. Huang W et al: Solitary plasmacytoma of cervical spine: treatment and prognosis in patients with neurological lesions and spinal instability. Spine (Phila Pa 1976). 35(8):E278-84, 2010
                                                8. Zuo Z et al: [Solitary plasmacytoma of bone: a clinicopathologic, immunohistochemical and immunoglobulin gene rearrangement study.] Zhonghua Bing Li Xue Za Zhi. 39(3):177-82, 2010
                                                9. Dingli D et al: Immunoglobulin free light chains and solitary plasmacytoma of bone. Blood. 108(6):1979-83, 2006
                                                10. Kumar S et al: Prognostic value of angiogenesis in solitary bone plasmacytoma. Blood. 101(5):1715-7, 2003
                                                11. Dimopoulos MA et al: Solitary bone plasmacytoma and extramedullary plasmacytoma. Curr Treat Options Oncol. 3(3):255-9, 2002
                                                12. Durr HR et al: Multiple myeloma: surgery of the spine: retrospective analysis of 27 patients. Spine. 27(3):320-4; discussion 325-6, 2002
                                                13. Gossios K et al: Solitary plasmacytoma of the spine in an adolescent: a case report. Pediatr Radiol. 32(5):366-9, 2002
                                                14. Wilder RB et al: Persistence of myeloma protein for more than one year after radiotherapy is an adverse prognostic factor in solitary plasmacytoma of bone. Cancer. 94(5):1532-7, 2002
                                                15. Alexandrakis MG et al: Value of Tc-99m sestamibi scintigraphy in the detection of bone lesions in multiple myeloma: comparison with Tc-99m methylene diphosphonate. Ann Hematol. 80(6):349-53, 2001
                                                16. Avva R et al: CT-guided biopsy of focal lesions in patients with multiple myeloma may reveal new and more aggressive cytogenetic abnormalities. AJNR Am J Neuroradiol. 22(4):781-5, 2001
                                                17. Ota K et al: A therapeutic strategy for isolated plasmacytoma of bone. J Int Med Res. 29(4):366-73, 2001
                                                18. Soderlund V et al: Diagnosis of skeletal lymphoma and myeloma by radiology and fine needle aspiration cytology. Cytopathology. 12(3):157-67, 2001
                                                19. Tsang RW et al: Solitary plasmacytoma treated with radiotherapy: impact of tumor size on outcome. Int J Radiat Oncol Biol Phys. 50(1):113-20, 2001
                                                20. Voss SD et al: Solitary osteosclerotic plasmacytoma: association with demyelinating polyneuropathy and amyloid deposition. Skeletal Radiol. 30(9):527-9, 2001
                                                21. Dimopoulos MA et al: Solitary plasmacytoma of bone and asymptomatic multiple myeloma. Blood. 96(6):2037-44, 2000
                                                22. Major NM et al: The "mini brain": plasmacytoma in a vertebral body on MR imaging. AJR Am J Roentgenol. 175(1):261-3, 2000
                                                23. Shah BK et al: Magnetic resonance imaging of spinal plasmacytoma. Clin Radiol. 55(6):439-45, 2000
                                                24. Liebross RH et al: Clinical course of solitary extramedullary plasmacytoma. Radiother Oncol. 52(3):245-9, 1999
                                                25. Lecouvet FE et al: Vertebral compression fractures in multiple myeloma. Part I. Distribution and appearance at MR imaging. Radiology. 204(1):195-9, 1997
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Synonyms

                                                            • Solitary bone plasmacytoma (SBP), solitary myeloma, solitary plasma cell tumor

                                                          • Definitions

                                                            • Solitary monoclonal plasma cell tumor of bone or soft tissue without evidence of multiple myeloma (MM)
                                                            • Diagnosis requires
                                                              • Solitary lesion, biopsy showing plasma cells
                                                              • Negative skeletal survey, negative MR spine, pelvis, proximal femora/humeri
                                                              • Negative clonal cells in marrow aspirate
                                                              • No anemia, hypercalcemia, or renal involvement suggesting systemic myeloma

                                                          IMAGING

                                                          • General Features

                                                            • Radiographic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Nonvascular Interventions

                                                                    • Nuclear Medicine Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Staging, Grading, & Classification

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Wang Y et al: Solitary plasmacytoma of bone of the spine: results from surveillance, epidemiology, and end results (SEER) registry. Spine (Phila Pa 1976). 44(2):E117-25, 2019
                                                                                              2. Caers J et al: Diagnosis, treatment, and response assessment in solitary plasmacytoma: updated recommendations from a European Expert Panel. J Hematol Oncol. 11(1):10, 2018
                                                                                              3. Dimopoulos MA et al: Role of magnetic resonance imaging in the management of patients with multiple myeloma: a consensus statement. J Clin Oncol. 33(6):657-64, 2015
                                                                                              4. Song IC et al: Diagnostic and prognostic implications of spine magnetic resonance imaging at diagnosis in patients with multiple myeloma. Cancer Res Treat. 47(3):465-72, 2014
                                                                                              5. Yang JS et al: Rapid progression of solitary plasmacytoma to multiple myeloma in lumbar vertebra. J Korean Neurosurg Soc. 54(5):426-30, 2013
                                                                                              6. Afonso PD et al: Solitary plasmacytoma of the spine: an unusual presentation. AJNR Am J Neuroradiol. 31(1):E5, 2010
                                                                                              7. Huang W et al: Solitary plasmacytoma of cervical spine: treatment and prognosis in patients with neurological lesions and spinal instability. Spine (Phila Pa 1976). 35(8):E278-84, 2010
                                                                                              8. Zuo Z et al: [Solitary plasmacytoma of bone: a clinicopathologic, immunohistochemical and immunoglobulin gene rearrangement study.] Zhonghua Bing Li Xue Za Zhi. 39(3):177-82, 2010
                                                                                              9. Dingli D et al: Immunoglobulin free light chains and solitary plasmacytoma of bone. Blood. 108(6):1979-83, 2006
                                                                                              10. Kumar S et al: Prognostic value of angiogenesis in solitary bone plasmacytoma. Blood. 101(5):1715-7, 2003
                                                                                              11. Dimopoulos MA et al: Solitary bone plasmacytoma and extramedullary plasmacytoma. Curr Treat Options Oncol. 3(3):255-9, 2002
                                                                                              12. Durr HR et al: Multiple myeloma: surgery of the spine: retrospective analysis of 27 patients. Spine. 27(3):320-4; discussion 325-6, 2002
                                                                                              13. Gossios K et al: Solitary plasmacytoma of the spine in an adolescent: a case report. Pediatr Radiol. 32(5):366-9, 2002
                                                                                              14. Wilder RB et al: Persistence of myeloma protein for more than one year after radiotherapy is an adverse prognostic factor in solitary plasmacytoma of bone. Cancer. 94(5):1532-7, 2002
                                                                                              15. Alexandrakis MG et al: Value of Tc-99m sestamibi scintigraphy in the detection of bone lesions in multiple myeloma: comparison with Tc-99m methylene diphosphonate. Ann Hematol. 80(6):349-53, 2001
                                                                                              16. Avva R et al: CT-guided biopsy of focal lesions in patients with multiple myeloma may reveal new and more aggressive cytogenetic abnormalities. AJNR Am J Neuroradiol. 22(4):781-5, 2001
                                                                                              17. Ota K et al: A therapeutic strategy for isolated plasmacytoma of bone. J Int Med Res. 29(4):366-73, 2001
                                                                                              18. Soderlund V et al: Diagnosis of skeletal lymphoma and myeloma by radiology and fine needle aspiration cytology. Cytopathology. 12(3):157-67, 2001
                                                                                              19. Tsang RW et al: Solitary plasmacytoma treated with radiotherapy: impact of tumor size on outcome. Int J Radiat Oncol Biol Phys. 50(1):113-20, 2001
                                                                                              20. Voss SD et al: Solitary osteosclerotic plasmacytoma: association with demyelinating polyneuropathy and amyloid deposition. Skeletal Radiol. 30(9):527-9, 2001
                                                                                              21. Dimopoulos MA et al: Solitary plasmacytoma of bone and asymptomatic multiple myeloma. Blood. 96(6):2037-44, 2000
                                                                                              22. Major NM et al: The "mini brain": plasmacytoma in a vertebral body on MR imaging. AJR Am J Roentgenol. 175(1):261-3, 2000
                                                                                              23. Shah BK et al: Magnetic resonance imaging of spinal plasmacytoma. Clin Radiol. 55(6):439-45, 2000
                                                                                              24. Liebross RH et al: Clinical course of solitary extramedullary plasmacytoma. Radiother Oncol. 52(3):245-9, 1999
                                                                                              25. Lecouvet FE et al: Vertebral compression fractures in multiple myeloma. Part I. Distribution and appearance at MR imaging. Radiology. 204(1):195-9, 1997