Case Report

Gastroduodenal Plasmacytoma Presenting with Jaundice

Authors: Selman Ünverdi, MD, Seyfettin Köklü; MD, Filiz Tuncer, MD, Murat Duranay, MD

Abstract

The duodenum and gastrointestinal tract are rarely involved by multiple myeloma, either diffusely or as a focal mass. A 59-year-old man was diagnosed with multiple myeloma and given chemotherapy. Four months later, he developed jaundice. Gastroduodenal plasmacytoma causing extrahepatic biliary obstruction was diagnosed. To the best of our knowledge, this case is the first report of gastroduodenal plasmacytoma presenting with biliary obstruction.


Key Points


* The gastrointestinal tract is rarely involved in cases of multiple myeloma.


* Duodenal infiltration by plasmacytoma is extremely rare.


* Duodenal plasmacytoma may present with obstructive jaundice.

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References

1 .Isomoto H, Ohnita K, Mizuta Y, et al. Clinical and endoscopic features of adult T-cell leukemia/lymphoma with duodenal involvement. J Clin Gastroenterol 2001;33:241–246.
 
2. Gonçalves R, Sousa R, Banhudo A, et al. Endoscopic findings in chronic lymphocytic leukemia. Am J Clin Oncol 2000;23:599–601.
 
3. Lu CH, Hsieh AT, Peng YJ, et al. Multiple myeloma presenting as gastric polyposis. Dig Dis Sci 2007;52:3340–3342.
 
4. Ohsaka A, Sato N, Imai Y, et al. Multiple gastric involvement by myeloid antigen CD13-positive non-secretory plasma cell leukaemia. Br J Haematol 1996;92:134–136.
 
5. Sakai H, Sawamura M, Tamura J, et al. A patient with primary plasma cell leukemia accompanied by an extensive polypoid infiltration of the gastrointestinal tract. J Med 1991;22:195–199.
 
6. Esfandyari T, Abraham SC, Arora AS. Gastrointestinal plasmacytoma that caused anemia in a patient with multiple myeloma. Nat Clin Pract Gastroenterol Hepatol 2007;4:111–115.
 
7. Prolla JC, Kirsner JB. The gastrointestinal lesions and complications of the leukemias. Ann Intern Med 1964;61:1084–1103.
 
8. Cornes JS, Jones TG. Leukaemic lesions of the gastrointestinal tract. J Clin Pathol 1962;15:305–313.
 
9. Barcos M, Lane W, Gomez GA, et al. An autopsy study of 1206 acute and chronic leukemias (1958 to 1982). Cancer 1987;60:827–837.
 
10. Derenzini E, Paolini S, Martinelli G, et al. Extramedullary myeloid tumour of the stomach and duodenum presenting without acute myeloblastic leukemia: a diagnostic and therapeutic challenge. Leuk Lymphoma 2008;49:159–162.
 
11. Jeon HJ, Akagi T. Unsuspected gastric granulocytic sarcoma in a patient with myelodysplastic syndrome. J Korean Med Sci 1996;11:68–76.
 
12. Nachbaur D, Duba HC, Feichtinger H, et al. Polychemotherapy combined with G-CSF-mobilized donor buffy coat transfusion for granulocytic sarcoma after allogeneic BMT for AML. Bone Marrow Transplant 1997;19:947–949.
 
13. D'Alteroche L, Mor C, Durand V, et al. [Gastric granulocytic sarcoma revealed by a massive digestive hemorrhage]. Gastroenterol Clin Biol 1999;23:779–782 [in French].
 
14. Robinson H, Damasiewicz M, Hönemann D, et al. Gastric involvement of plasmacytoma associated with t(4:14) and chromosome 13 deletion. Leuk Lymphoma 2006;47:1973–1975.
 
15. Chim CS, Wong WM, Nicholls J, et al. Extramedullary sites of involvement in hematologic malignancies: case 3. Hemorrhagic gastric plasmacytoma as the primary presentation in multiple myeloma. J Clin Oncol 2002;20:344–347.
 
16. Colović M, Janković G, Suvajdzić N, et al. Thirty patients with primary plasma cell leukemia: a single center experience. Med Oncol 2008;25:154–160.
 
17. Gradishar W, Recant W, Shapiro C. Obstructing plasmacytoma of the duodenum: first manifestation of relapsed multiple myeloma. Am J Gastroenterol 1988;83:77–79.
 
18. Isomoto H, Nishida Y, Fukuda H, et al. Two cases of adult T-cell leukaemia/lymphoma View Full Text | PubMed | CrossRef