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History


Patient History

64 year old man presents with nasal congestion, bilateral hearing loss and mass in throat.

Exam


Physical Exam and Laboratory

Mass in nose and throat.

Caption


Axial :: MR - T1W w/Gadolinium :: ACR Code: 2.3

Central Skull Base Plasmacytoma

Infiltrative and destructive central skull base mass with both intra and extracranial extension. Mass is lobulated, destroys bone and enhances following contrast administration. Mucosal thickening right maxillary sinus.


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Findings


Summary of Findings

Infiltrative and destructive central skull base mass with both intra and extracranial extension. Mass is lobulated, destroys bone, and enhances following contrast administration.

Diffferential


Differential Diagnosis

• Lymphoma
• Nasopharyngeal carcinoma
• Chordoma
• Metastatic disease
• Chloroma, plasmacytoma

Diagnosis


Diagnosed by: Needle biopsy and pathological examination

Plasmacytoma

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Treatment


Treatment and Followup

Radiation therapy and Chemotherapy

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Topic

This Image: 57103 - is linked to Topic: 160

Topic: plasmacytoma
Plasma cells - primary source of immunoglobulins, found in LN, GI submucosa, and bone marrow. A plasmacytoma is a localized lesion, usually of bone composed of monoclonal plasma cells. Most cases +> multiple myeloma, and solitary presenting masses require careful evaluation to exclude other lesions. Some cases of "plasmacytoma" that do not progress to multple myeloma (MM) may be "plasma cell granuloma". Two criteria (Griffiths) for plasmacytoma: survival >12 yrs w/o dissemination and negative bone marrow at autopsy. Conversion to MM usu by 5yrs, rarely >20. Solitary lesions usu spine, pelvis, or extraskeletal (nasal, sinuses, upper airway).
XR - multicystic, expansile w/thickened trabeculae (e.g. AFIP 2468693); pure lytic w/o expansion; pure sclerotic (ivory vertebrae). In spine, may cross intervertebral disc, and simulate infection. Plasmacytoma at any juxtaarticular site may cross joint.
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57103
MedPix™ 57103
 View - Edit		 Title: Central Skull Base Plasmacytoma
Caption:
Infiltrative and destructive central skull base mass with both intra and extracranial extension. Mass is lobulated, destroys bone and enhances following contrast administration. Mucosal thickening right maxillary sinus.
Image Modality: MR - T1W w/Gadolinium
Image Plane: Axial
Image/Caption Source: Steven J Goldstein
MedPix™ Caption 57103
Caption/Image Contributor: Steven J Goldstein - Author Info :: Send Email
Affiliation: University of Kentucky

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    Credits


    TF Case Contributor Credits
    Topic Author(s): 11983
    		Submitted by: Steven J Goldstein - Author Info
    Case/Image Editor: James G. Smirniotopoulos, M.D. - Editor Info
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