Sunil Pasricha1, Himanshi Diwan1, Divya Bansal2, Ankush Jajodia3, Mudit Agarwal4, Gurudutt Gupta1, Anila Sharma1, Garima Durga1, Meenakshi Kamboj1, Venkata Pradeep Babu Koyyala5, Anurag Mehta6. 1. Department of Histopathology and Cytopathology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, 110085, India. 2. Department of Histopathology and Cytopathology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, 110085, India. divyabansalrgci@gmail.com. 3. Department of Radiology, Juravinski Cancer Centre and St. Joseph's Healthcare Hamilton, Hamilton, Canada. 4. Department of Head and Neck Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, 110085, India. 5. Department of Medical Oncology, ACCF (TATA Trusts), Guwahati, Assam, India. 6. Laboratory Services & Molecular Diagnostics, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, 110085, India.
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.
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.