Extramedullary Plasmacytoma of the Small Intestine: A Case Report

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Extramedullary plasmacytoma (EMP) of the gastrointestinal tract is an uncommon-type of neoplasms.This report describes a case of EMP in the small intestine. A 78-year-old male,with abdominaldiscomfort and vomiting, was found to have a 7-cm sized tumor of the small intestine and swollenlymph nodes. He underwent resection of the bowel and lymph nodes. Histological examination of theresected specimens revealed compact tumor cells from mucosa to subserosa and infiltrate into the fat tissueof the mesentery and the lymph nodes. Pathological examination of the resected specimen revealedplasma cell-like round cells, Dutcher bodies, and Russell bodies. Immunohistochemical examinationshowed that the cytoplasm of the tumor cells were positive for CD138 and the nuclei were positive forcyclin D1. Four months after surgical resection, the patient had recurrence of tumor cells in thepara-aortic lymph nodes and lumbar vertebrae. Chemotherapy treatment was ineffective. Surgicalresection followed by chemotherapy is thought to be effective in the case of intestinal obstruction,although there is a possibility of devastation which is resistant to chemotherapy. We propose that tumorcells positive for cyclin D1 may play a key role in devastation and could be a useful indicator ofprognosis.
2007-08-01