Korean J Radiol.  2015 Feb;16(1):146-153. 10.3348/kjr.2015.16.1.146.

Pelvic Solitary Plasmacytoma: Computed Tomography and Magnetic Resonance Imaging Findings with Histopathologic Correlation

• Wang Y
• Zhu XL
• Peeroo MW
• Qian ZH
• Shi D
• Wei SM
• Yu RS

• KMID: 2069993
• DOI: http://doi.org/10.3348/kjr.2015.16.1.146

Abstract

OBJECTIVE
To describe the imaging features of pelvic solitary plasmacytoma and to correlate them with the pathologic grade.
MATERIALS AND METHODS
A retrospective study was performed on the imaging features of 10 patients with a histological diagnosis of pelvic solitary plasmacytoma. The imaging studies were assessed for bone expansion, cortical destruction, signal intensity/density of soft tissue mass and enhancement manifestations, which were then correlated to the pathologic grade.
RESULTS
The imaging features of pelvic solitary plasmacytoma revealed 3 different types: multilocular type (n = 5), unilocular type (n = 2) and complete osteolytic destruction type (n = 3) on computed tomography and MRI. Pathologically, the tumors were classified into low, intermediate and high grades. Features such as multilocular change, perilesional osteosclerosis, slight expansion, local bone cortex disruptions and masses inside bone destruction, often suggest a low-grade solitary plasmacytoma; complete osteolytic destruction, huge soft tissue mass, and osseous defects imply a higher pathologic grade.
CONCLUSION
Pelvic solitary plasmacytoma has various imaging manifestations, while a slight expansile osteolytic feature with multilocular change or homogeneous enhancement highly suggests its diagnosis. The distinctive imaging features of pelvic solitary plasmacytoma are well correlated to the pathologic grade.

Keyword

Plasmacytoma; Pelvic neoplasms; Computed tomography; Magnetic resonance imaging; Pathologic grade

MeSH Terms

Adult
Aged
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Grading
Pelvic Neoplasms/*pathology/radiography
Plasmacytoma/*pathology/radiography
Retrospective Studies
Tomography, X-Ray Computed

Figure

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  Fig. 1 Unilocular type solitary plasmacytoma in 58-year-old female (case 6). A. Pathologic hematoxylin and eosin staining (× 400) demonstrates low-grade plasmacytoma with plasma cells indistinguishable from normal cells. B. Unenhanced CT shows slight expansile osteolytic lesion with perilesional osteosclerosis. C. Contrast-enhanced CT shows lesion with marked homogeneous enhancement.

• 

  Fig. 2 Multilocular type solitary plasmacytoma in 52-year-old man (case 3). A. Pathologic hematoxylin and eosin staining (× 400) demonstrates intermediate-grade plasmacytoma with plasma cells containing large eccentric nuclei with prominent nucleoli and abundant basophilic cytoplasm. B, C. Bone window CT shows slight expansile osteolytic lesion with partial multilocular change (B) and local bone cortex interruption (C) in right ilium.

• 

  Fig. 3 Complete osteolytic destruction type solitary plasmacytoma in 75-year-old female (case 9). A. Pathologic hematoxylin and eosin staining (× 400) demonstrates high-grade plasmacytoma with many cells exhibiting plasmablastic features with frequent mitoses. B. Enhanced T1-weighted image in axial plane shows heterogeneous enhancement of soft tissue mass in right ilium.

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  Fig. 4 Multilocular type solitary plasmacytoma in 57-year-old female (case 2). A, B. Axial fat suppressed T2-weighted sequences (A) and diffusion-weighted imaging (B) shows high signal with linear low signal within lesion in sacrum.

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  Fig. 5 Multilocular type solitary plasmacytoma in 56-year-old man (case 1). T1-weighted images and T2-weighted images in sagittal plane show low signal of lesions and high signal of fifth lumbar vertebra after radiotherapy.

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