Plasma cell myeloma - a unique case presenting as thyroid plasmacytoma and mimicking of medullary carcinoma: how to avoid pitfall in aspiration cytology
Authors: Sinem Kantarcioglu Coskun, Asli Naldemir, Mehmet Gamsizkan, Binnur Onal
Background: Extramedullary plasmacytoma (EMP) of the thyroid is a rare neoplasm that may present either as a solitary plasmacell tumor or involvement of plasma cell myeloma (PCM). In this report, we present a unique case of PCM presented as a thyroid mass without previous history, and initially misinterpreted as medullary carcinoma on fine-needle aspiration cytology (FNAC). Case Presentation: A 77-year-old female presented with shortness of breath and palpitation. Ultrasonography-guided FNAC from the large thyroid mass revealed hypercellular smears composed of monomorphic plasmacytoid cells, focally binucleated, scattered diffusely. Subsequent histopathological examination and immunohistochemistry of thyroidectomy specimen showed infiltration of sheets of plasma cells and diagnosed as EMP. Histology of the bone marrow displayed Lambda positive neoplastic plasma cells. A combination of singly distributed cells and aggregates with plasmacytoid morphology on a proteinous background without clinical suspicion and previous history leads to misinterpretation of FNAC. Conclusion: Clinical correlation, immunocytochemistry, and complementary cytological approach including various preparation techniques of staining are crucial for avoiding diagnostic pitfalls and the patients' proper treatment.
Keywords: Plasma cell myeloma, case report, thyroid, cytology, medullary carcinoma, FNAC.
Authors
Correspondence to:
Sinem Kantarcioglu Coskun, Department of Pathology & Cytology, School of Medicine, Duzce University, Konuralp Campus, Turkey drskcoskun@gmail.com
Publication history:
Received 12 Apr 2022
Revised 09 Aug 2022
Accepted 24 Aug 2022
Published online 12 Sep 2022
Published in print 16 Oct 2022
Coskun SK, Naldemir A, Gamsizkan M, Onal B. Plasma cell myeloma - a unique case presenting as thyroid plasmacytoma and mimicking of medullary carcinoma: how to avoid pitfall in aspiration cytology. EJMCR. 2022; 6(6): 91-94. doi:
10.24911/ejmcr/173-1638536657
Coskun SK, Naldemir A, Gamsizkan M, Onal B. Plasma cell myeloma - a unique case presenting as thyroid plasmacytoma and mimicking of medullary carcinoma: how to avoid pitfall in aspiration cytology. https://www.ejmcr.com/?mno=37686 [Access: March 29, 2024]. doi:
10.24911/ejmcr/173-1638536657
Coskun SK, Naldemir A, Gamsizkan M, Onal B. Plasma cell myeloma - a unique case presenting as thyroid plasmacytoma and mimicking of medullary carcinoma: how to avoid pitfall in aspiration cytology. EJMCR. 2022; 6(6): 91-94. doi:
10.24911/ejmcr/173-1638536657
Coskun SK, Naldemir A, Gamsizkan M, Onal B. Plasma cell myeloma - a unique case presenting as thyroid plasmacytoma and mimicking of medullary carcinoma: how to avoid pitfall in aspiration cytology. EJMCR. (2022), [cited March 29, 2024]; 6(6): 91-94. doi:
10.24911/ejmcr/173-1638536657
Coskun, S. K., Naldemir, . A., Gamsizkan, . M. & Onal, . B. (2022) Plasma cell myeloma - a unique case presenting as thyroid plasmacytoma and mimicking of medullary carcinoma: how to avoid pitfall in aspiration cytology. EJMCR, 6 (6), 91-94. doi:
10.24911/ejmcr/173-1638536657
Coskun, Sinem Kantarcioglu, Asli Naldemir, Mehmet Gamsizkan, and Binnur Onal. 2022. Plasma cell myeloma - a unique case presenting as thyroid plasmacytoma and mimicking of medullary carcinoma: how to avoid pitfall in aspiration cytology. European Journal of Medical Case Reports, 6 (6), 91-94. doi:
10.24911/ejmcr/173-1638536657
Coskun, Sinem Kantarcioglu, Asli Naldemir, Mehmet Gamsizkan, and Binnur Onal. "Plasma cell myeloma - a unique case presenting as thyroid plasmacytoma and mimicking of medullary carcinoma: how to avoid pitfall in aspiration cytology." European Journal of Medical Case Reports 6 (2022), 91-94. doi:
10.24911/ejmcr/173-1638536657
Coskun, Sinem Kantarcioglu, Asli Naldemir, Mehmet Gamsizkan, and Binnur Onal. "Plasma cell myeloma - a unique case presenting as thyroid plasmacytoma and mimicking of medullary carcinoma: how to avoid pitfall in aspiration cytology." European Journal of Medical Case Reports 6.6 (2022), 91-94. Print. doi:
10.24911/ejmcr/173-1638536657
Coskun, S. K., Naldemir, . A., Gamsizkan, . M. & Onal, . B. (2022) Plasma cell myeloma - a unique case presenting as thyroid plasmacytoma and mimicking of medullary carcinoma: how to avoid pitfall in aspiration cytology. European Journal of Medical Case Reports, 6 (6), 91-94. doi:
10.24911/ejmcr/173-1638536657