What is the pathophysiology of solitary plasmacytoma?

Updated: Dec 31, 2019
  • Author: Suzanne R Fanning, DO; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

A plasmacytoma can arise in any part of the body. A solitary bone plasmacytoma (SBP) arises from the plasma cells located in the bone marrow, whereas an extramedullary plasmacytoma (EMP) is thought to arise from plasma cells located in mucosal surfaces. [3] Both represent a different group of neoplasms in terms of location, tumor progression, and overall survival rate. [4, 5] Some authors suggest that SBPs represent marginal cell lymphomas with extensive plasmacytic differentiation. [5] Both SBP and extramedullary plasmacytoma (EMP) do, however, share many of the biologic features of other plasma cell disorders.

Cytogenetic studies show recurrent losses in chromosome 13, chromosome arm 1p, and chromosome arm 14q, as well as gains in chromosome arms 19p, 9q, and 1q. [6] Interleukin-6 (IL-6) is still considered the principal growth factor in the progression of plasma cell disorders. [7]

The specific roles of surface markers, adhesion molecules, and angiogenesis in solitary plasmacytoma need to be studied further.

In a study by Kumar et al, high-grade angiogenesis in SBP was associated with increased progression to multiple myeloma and shorter progression-free survival. Some have postulated that SBP may be considered an intermediate step in the evolution from monoclonal gammopathy of undetermined significance to multiple myeloma. [7, 8]


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