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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(04): 997-1002
DOI: 10.4103/ajns.AJNS_184_20
Case Report

Solitary plasmacytoma with amyloid – An unusual dural-based lesion

Pooja Gajaria
Department of Pathology, Seth G S Medical College, KEM Hospital, Mumbai, Maharashtra
,
Asha Shenoy
Department of Pathology, Seth G S Medical College, KEM Hospital, Mumbai, Maharashtra
,
Jayashri Chaudhari
Department of Pathology, Seth G S Medical College, KEM Hospital, Mumbai, Maharashtra
,
Naina Goel
Department of Pathology, Seth G S Medical College, KEM Hospital, Mumbai, Maharashtra
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Solitary plasmacytoma of the dura without systemic involvement are extremely rare lesions, with <15 cases reported in the literature. Among these, ours is the second case to show the presence of amyloid. Fifty-year-old male had presented with headache, sudden onset right-sided weakness, and vomiting. Magnetic resonance imaging revealed an extra-axial mass in the left fronto-parietal region measuring 10 cm × 8.7 cm × 3.9 cm, suggestive of meningioma. The left fronto-parietal craniotomy was performed and multiple tissue bits aggregating to 10 cm × 8.5 cm × 2 cm along with thinned out membrane-like bit of calvarium was sent for pathologic examination. H and E stained sections showed sheets of plasmacytoid cells along with amyloid, which showed apple-green birefringence on Congo red staining. On immunohistochemistry, tumor cells were positive for CD38, CD138, showed kappa light chain restriction and were negative for CD45, CD34. Hence, it was diagnosed as a plasma cell neoplasm. Further work-up with whole-body positron-emission tomography scan revealed no systemic involvement. Dural-based lesions can mimic meningioma radiographically as well as intraoperatively. Histopathological examination unveils the diagnosis, to guide appropriate therapeutic regimens.

Key-words:

Amyloid - dura - immunohistochemistry - plasmacytoma - solitary

Financial support and sponsorship

Nil.




Publication History

Received: 29 April 2020

Accepted: 24 September 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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