
Abstract: Solitary plasmacytoma of bone is one of many existing types of bone tumors and is part of the plasma cell disorder spectrum. It is a local clonal plasma cell proliferation without evi dence of symptomatic multiple myeloma. It occurs slightly more frequently in males with a median age at diagnosis of 55 years. The thoracic vertebrae are most frequently involved. The exact etiology is unknown, although a role for acquired B-cell defects is suggested. In children and young adults, pre ceding trauma might play a role in the devel opment of solitary plasmacytoma of bone. Compared to extramedullary plasmacytoma, solitary plasmacytoma of bone has a signifi cantly worse prognosis, progressing to symp tomatic multiple myeloma in over 50% of cases. The survival rates are significantly worse in case of abnormal serum immuno globulin free light chain ratio, in patients diag nosed after the age of 60 years and in female patients. In one-third of presumed “solitary” plas macytomas, an additional lesion is character ized with subsequent diagnostic imaging, marking the importance of further investiga tions when an apparent solitary plasmacytoma of bone is encountered. Conventional radiog raphy plays a distinct role in the imaging and detection of solitary plasmacytoma of bone, mostly in the presence of clear clinical symp toms. It may show a “punched-out” lesion appearance with generally clear margins and normal surrounding bone. More advanced cases may be paired with marked erosion and cortical bone destruction, creating a “soap bubble” appearance. On CT, solitary plasma cytoma of bone presents as a uni- or multiloc ular lesion, causing focal trabecular destruction. A characteristic “mini brain” appearance may be observed. On conventional MRI, a plasmacytoma is iso- to hypointense on T1-weighted images and hyperintense on (fat-saturated) T2-weighted images compared to muscle and enhances homogeneously gadolinium contrast administration. Specialized MRI techniques such as dynamic contrast-enhanced MRI and diffusion-weighted imaging also play an important role, especially in assessing disease extent and dif ferentiation with multiple myeloma, where a focal solitary plasmacytoma of bone is accompanied by surrounding or distant bone marrow invasion. 18F-FDG PET/CT is useful in the evaluation and has a prognostic value both at diagnosis and in the evaluation of treatment.
Extramedullary plasmacytoma, Plasma cell disorders, Radiotherapy, Medicine and Health Sciences, Human medicine, Solitary plasmacytoma of bone, Spine, Imaging
Extramedullary plasmacytoma, Plasma cell disorders, Radiotherapy, Medicine and Health Sciences, Human medicine, Solitary plasmacytoma of bone, Spine, Imaging
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