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• W4254514215 abstract "FigureA 64 year-old man with a history of relapsed multiple myeloma with multiple subcutaneous masses on his scalp, face, chest, and back that were biopsy-proven plasmacytomas presented to our institution for evaluation of gastric polypoid lesions noted on an outside endoscopic evaluation. We performed esophagogastroduodenoscopy that showed multiple polypoid lesions (5-15 mm) of two types in the body and proximal stomach. One set were erythematous polypoid lesions with the largest having a subtle central depression. The other polyps were pale, fundic gland type polyps. One representative lesion from both groups was removed by snare polypectomy. The duodenum and esophagus were normal. Pathology on the polyps showed a fundic gland polyp and a plasmacytoma involving the gastric body with CD138+ immunostaining. He has since been referred for salvage chemotherapy with elotuzumab, lenalidomide and dexamethasone with plans for an eventual autologous hematopoietic cell transplant. The malignant plasma cells of multiple myeloma are typically confined to the bone marrow. However, masses of neoplastic monoclonal plasma cells may present as solitary lesions in soft tissues other than bone. Such extramedullary plasmacytomas (EMPs) are uncommon, accounting for 3% of all plasma cell neoplasms. Even less common is gastrointestinal (GI) tract involvement by EMPs, occurring in < 5% of all EMPs. The small bowel is the most common site of GI involvement followed by the stomach, colon, and esophagus. The endoscopic appearance of gastric plasmacytomas is protean with presentations ranging from ulcerated multilobulated or polypoid masses to discrete ulcers with thickened folds and may mimic gastrointestinal stromal tumors, lymphoma, amyloidosis, or carcinoma. Most patients with gastric plasmacytomas are elderly and may present with anorexia, weight loss, abdominal pain, vomiting, occult blood loss and rarely overt GI bleeding. Small or large intestine involvement may result in obstruction or malabsorption. Final diagnosis must be made by histologic confirmation with immunohistochemical staining. The prognosis of GI involvement by EMPs is generally very poor despite aggressive therapy. In patients with a history of a hematologic malignancy, gastric plasmacytoma should remain in the differential diagnosis of gastric polyps.Figure 1Figure 2" @default.
• W4254514215 created "2022-05-12" @default.
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• W4254514215 date "2016-10-01" @default.
• W4254514215 modified "2023-09-27" @default.
• W4254514215 title "Gastric Plasmacytoma: an Uncommon Cause of a Common Endoscopic Finding" @default.
• W4254514215 doi "https://doi.org/10.1038/ajg.2016.382" @default.
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