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Clinical Problem Solving: Pathology
June 21, 2010

Pathology Quiz Case 2: Diagnosis

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2010;136(6):636-637. doi:10.1001/archoto.2010.67-b

Diagnosis: Extramedullary plasmacytoma (EMP)

Extramedullary plasmacytoma is a rare presentation of plasma cell dyscrasia, accounting for approximately 3% of all plasma cell neoplasms.1These tumors are characterized by a discrete solitary mass of neoplastic, monoclonal plasma cells and are not associated with end-organ damage, hypercalcemia, or infections, as seen in multiple myeloma.2Eighty percent of EMPs occur in the upper respiratory tract, including the nasal cavity, sinuses, nasopharynx, and larynx.2Other less common locations include the gastrointestinal tract, central nervous system, thyroid, breasts, testicles, parotid gland, and lymph nodes.3Extramedullary plasmacytomas are 4 times more common in males, and 90% of cases occur in whites.4Seventy percent of patients are between the ages of 40 and 70 years.4