Extramedullary endobronchial plasmacytoma.

To cite: Fernández-Bussy S, Labarca G, Folch E, et al. BMJ Case Reports Published online: [please include Day Month Year] doi:10.1136/ bcr-2012-007354 DESCRIPTION A 58-year-old man with a history of multiple myeloma was admitted to the hospital with progressive dyspnoea and hypoxemia. Chest examination revealed decreased breath sounds bilaterally. Blood examination revealed anaemia. Chest x-ray and chest CT scan revealed multiple pulmonary nodules, segmental atelectasis and central bronchial narrowing. Flexible bronchoscopy showed nodular lesions with extensive mucosa and submucosal infiltration, which extended from the proximal bronchus intermedius to the right lower lobe bronchus. A large nodular lesion was also noted at the posterior membrane of the proximal left mainstem bronchus (figure 1) and in the rigth bronchus intermedius (figure 2). Biopsies were taken with flexible forceps. Endobronchial biopsies showed extensive tumour infiltration with plasmocytoid cells, ovoid irregular excentric nuclei, prominent nucleoli, eosinophilic cytoplasm with a paranucleus pale area. High mitosis rate and frequent apoptotic figures were seen (figure 3). Immunohistochemistry was positive for CD-138 and MUM-1. Only κ-light immunoglobulin chains were noted. This results suggest that the tumor was plasma cell origin with light chain restriction. Extramedullary plasmacytoma (EMP) is a plasma cell neoplasm that arises outside the bone. EMP is rare and is observed in only 5% of all plasmacytomas. Endobronchial plasmacytoma is a rare manifestation from EMP. 2