Abstract
Background
Plasmacytoma involving thyroid gland is infrequent and can present as either primary extramedullary plasmacytoma or secondary to multiple myeloma.
Methods and Results
We present a case of 71 years old male who complained of a huge anterior neck swelling accompanied by dysphagia and dyspnoea. Fine needle aspiration cytology was suggestive of anaplastic carcinoma of thyroid (ATC), however, the subsequent histomorphology supported by immunohistochemistry (IHC) astoundingly favoured the diagnosis of plasmacytoma. Further evaluation revealed the presence of lymphadenopathy and single bone lesion in the present case which was rather suggestive of secondary involvement of thyroid to multiple myeloma. However, the case was unique in view of its presentation as a rapidly enlarging thyroid mass associated with stridor and cytomorphological findings which were of an undifferentiated malignancy favouring ATC. The use of a broad and judicious IHC panel clinched the final diagnosis of plasmacytoma.
Conclusion
The present case emphasizes the diligent use of IHC in such cases given different therapeutic and prognostic implications.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data Availability
Availability of data and material is possible upon reasonable request, deidentified for maintenance of anonymity and compliance with IRB approval.
Code Availability
Not applicable. All authors confirm they have meaningfully contributed to the research and read and approved the final manuscript.
References
Refai F, Gomaa W, Abdullah L. A case report of thyroid plasmacytoma and literature update. J Microsc Ultrastruct. 2020;8:75–9.
Ridal M, Ouattassi N, Harmouch T, Amarti A, Alami MN. Solitary extramedullary plasmacytoma of the thyroid gland. Case Rep Otolaryngol. 2012;2012:282784.
Hassan MJ, Khan S, Pujani M, Jetley S, Raina PK, Ahmad R. Extramedullary plasmacytoma of the thyroid: Report of a rare case. Blood Res. 2014;49:280–3.
Bhat V, Shariff S, Reddy RA. Extramedullary plasmacytoma of thyroid-a mimicker of medullary carcinoma of fine needle aspiration cytology: a case report. J Cytol. 2014;31:53–6.
Crabtree M, Ji P, Cai JC, Qing X. Extraosseous plasmacytoma of thyroid arising in Hashimoto’s thyroiditis. J Hematal Oncol Res. 2020;4:6–16.
Wysocki MS, Weber K. Solitary extramedullary plasmacytoma of the thyroid gland in a patient with subclinical hyperthyroidism. AACE Clin Case Rep. 2021;7:303–6.
McKenna RW, Kyle RA, Kuehl WM, Harris NL, Coupland RW, Fend F. Plasma cell neoplasms. In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, editors. WHO Classification of tumors of Hematopoietic and lymphoid tissues. Revised 4. Lyon: International Agency for Research on Cancer; 2017. p. 241–58.
Zukerberg LR, Ferry JA, Conlon M, Harris NL. Plasma cell myeloma with cleaved multilobated and monocytoidnuclei. Am J Clin Pathol. 1990;93:657–61.
Zanelli M, Mengoli MC, Fanni D, Froio E, Marco LD, AscaniS. Multiple myeloma with multilobated plasma cells: an unusual and challenging morphological variant. Int J Surg Pathol. 2018;26:439.
Cambruzzi E, Molinari AS, Uchoa DM, Yepez V. Primary plasmacytoma of the thyroid gland: a case report of a rare neoplasia. J Bras Patol Med Lab. 2012;48:281–5.
Gochhait D, Govindarajalou R, Kar R, Rangarajan V, Dehuri P, Dubashi B. Plasmacytoma of thyroid clinically and morphologically mimicking primary thyroid carcinoma. Cytopathology. 2019;2019:113–6.
Kovacs CS, Mant MJ, Nguyen GK, Ginsberg J. Plasma cell lesions of the thyroid: Report of a case of solitary plasmacytoma and a review of the literature. Thyroid. 1994;4:65–71.
Ragazzi M, Ciarrocchi A, Sancisi V, Gandolfi G, Bisagni A, Piana S. Update on anaplastic thyroid carcinoma: morphological, molecular, and genetic features of the most aggressive thyroid cancer. Int J Endocrinol. 2014;2014:790834.
Funding
The authors did not receive support from any organization for the submitted work nor was there any funding to conduct the study or to assist with manuscript preparation.
Author information
Authors and Affiliations
Contributions
Substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data–SP, DB, MK, MA, AJ. Drafting the article and revising it critically for important intellectual content–SP, HD, GG, AS, GD, VPBK. Final approval of the version to be published–SP, DB, HD.
Corresponding author
Ethics declarations
Conflicts of interest
All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.
Ethical Approval
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board (Rajiv Gandhi Cancer Institute & Research Centre),vide the ethical approval letter number RGCIRC/IRB-BHR/44/2022.
Consent to Participate and Publication
Written informed consent was obtained from the patient for publication of this case report and accompanying images.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Pasricha, S., Diwan, H., Bansal, D. et al. Intrathyroidal Plasmacytoma with Pleomorphic Multilobated Bizarre Cells: A Rare Primary Clinicopathological Presentation Mimicking Anaplastic Carcinoma of Thyroid. Head and Neck Pathol 16, 1257–1262 (2022). https://doi.org/10.1007/s12105-022-01465-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12105-022-01465-2