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Solitary Plasmacytoma : Bone

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Definition: Solitary plasmacytoma of bone is a localized clonal proliferation of immunoglobulin producing plasma cells. By definition, there is no bone marrow involvement at other sites. The clinical features of multiple myeloma are absent. There is no evidence of widespread bone lesions by skeletal survey. Renal failure, anemia and hypercalcemia are not present. There may be low levels of serum/urine M component in about 50% of cases. The levels of polyclonal immunoglobulins in serum are normal.

Locations: The most commonly involved location is thoracic spine (40% to 50% cases), followed by lumbar/cervical spine, skull, ribs, pelvis, clavicle, scapula, and femur. About 5% of patients with "solitary" plasmacytoma of bone have multiple lesions but still lack clinical features of multiple myeloma.

This MRI image (T2; sagittal view) is from a 50 y/o male who presented with 1 month history of tingling sensation in his lower extremities. There was no history of trauma. The image shows an expansile soft tissue lesion involving only the L1 vertebra. There was no evidence of other skeletal lesions. Case courtesy of Dr Prashant Gupta, Radiopaedia.org. From the case rID: 17832

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