%0 Journal Article
%T Primary Pulmonary Plasmacytoma with Diffuse Alveolar Consolidation: A Case Report
%A Zohreh Mohammad Taheri
%A Forouzan Mohammadi
%A Mehrdad Karbasi
%A Leila Seyfollahi
%A Shahram Kahkoei
%A Mojtaba Ghadiany
%A Nader Fayazi
%A Davood Mansouri
%J Pathology Research International
%D 2010
%I Hindawi Publishing Corporation
%R 10.4061/2010/463465
%X Solitary extramedullary plasmacytomas are plasma cell tumors that tend to develop in mucosa-associated lymphoid tissues including the sinonasal or nasopharyngeal regions. Primary plasmacytoma of the lung is exceedingly rare and often presents as a solitary mass or nodule in mid-lung or hilar areas and diagnosed after resection. Herein, we report a case of primary pulmonary plasmacytoma that presented with diffuse alveolar consolidation and diagnosed by transbronchial lung biopsy. 1. Introduction Extramedullary plasmacytoma (EMP) comprises roughly 3%¨C5% of all plasma cell neoplasms. Eighty percent of EMP occurs in the head and neck and most cases involve the upper aerodigestive tract [1]. Primary pulmonary plasmacytoma (PPP) is a rare type of extramedullary plasmacytoma and usually present with a nodule or mass in hilar areas. Diffuse alveolar consolidation is exceedingly rare and reported in two cases [2, 3]. Here we report a case of PPP with unusual presentation. 2. Clinical History A 60-year-old nonsmoker female with a chief complaint of dyspnea (function class III to IV) from three days before referred to our center. She had a 6-month history of dry cough which changed to purulent productive cough 20 days prior to admission, in addition to solid meal dysphagia, fever, chills, sweating, weight loss, and loss of appetite. She was hospitalized with a diagnosis of unspecified pneumonia. She had a history of coronary artery angioplasty eight months ago and vague history of rheumatoid arthritis. She used corticosteroids, atorvastatin, verapamil, and digoxin for the past 6 months. Her vital signs were: BP 140/80£¿mmHg, PR 85/min, RR 23/min, T 38¡ãC. She had respiratory distress and central cyanosis. Pulmonary exam showed diffuse wheezing and fine and coarse crackles were heard over the lungs. Chest X-ray demonstrated bilateral alveolar consolidation which was more prominent in the lower part of the left lung. Bilateral hilar prominency, mild increase in mediastinal diameter without a gross bone lesion was also apparent. Arterial blood gas showed: pH 7.42, Pco2 43.9£¿mmHg, Hco3 27.6, Po2 40.2£¿mmHg, O2 sat 77.1%. Routine laboratory exams including biochemistry tests and complete blood count were normal. Angiotensin converting enzyme (ACE) and rheumatological tests were normal as well, but ESR was elevated to 94£¿mm in the first hour. Echocardiography showed mildly-reduced left ventricle function with an ejection fraction of 40%, right-sided wall motion abnormality and mild mitral valve regurgitation. Doppler sonography of the lower extremity veins did not show
%U http://www.hindawi.com/journals/pri/2010/463465/