Clinicopathological characteristics of primary gastric plasmacytoma : report of a case and review of literature

SHI Yan-hong; DONG Bing-wei; WANG Xing-yue

doi:10.3969/j.issn.1007-8096.2017.11.008

Abstract：Objective To investigate the pathological features,diagnosis and treatment of primary gastric plasmacytoma.Methods A case of primary gastric plasmacytoma was examined by histopathology and immunohistochemistry,and the literature was reviewed.Results The tumor located in the body of the stomach.The tumor was about 6 cm x 5 cm x 3 cm in size,scattered around the ulcer in the polypoid tumor,with the largest diameter of 6 cm.Microscopy showed that the mass was composed of clusters of typical plasmacytoma cells with a spoke-wheel-like nuclei or eccentric nuclei.Occasional bi-and multi-nucleation and 1-2 mitotic figures were observed in per high-power field.The tumor had infiltrated into the entire gastric wall.Diffuse lamellar arrangement of tumor cells was noted.The immunohistochemical findings showed that the tumor cells were positive for PAX-5,CD138,CD38,Pan-CK,EMA,CD30,MUM-1,vimentin and CD10,and negative for Kappa,Lambda,EBV,EBER,CK7,CDS,CD20,CD56,CD79α,CD4,CD8,CD45,CD43,CD68,S-100,MelanA,HMB45,CD34,CDl17,DOG-l,CEA,Bcl-6,PAX-8,CD3,ALK,Granzyme B and TIA.The Ki-67 labeling index was high (about 80％);D2-40 showed that the formation of intravascular tumor embolus.Conclusion Primary gastric plasmacytoma is rare and few cases have been reported before.This tumor is easily misdiagnosed,because the tumors lack the specific clinical manifestations and imaging;its definitive diagnosis depends on pathological examination,and immunohistochemistry is helpful for differential diagnosis.