Mediastinal plasmocytoma with multiple myeloma: unusual presentation

Nouama Bouanani, Sophia Berrada

PAMJ-CM. 2020; 3:162. Published 05 Aug 2020 | doi:10.11604/pamj-cm.2020.3.162.24211

We report a rare case about a 60 years old Moroccan woman with a past medical history of gastrointestinal tuberculosis, admitted to the emergency department with fever, coughing, weight loss, Spontaneous sternum fracture, back and chest pain. A physical examination revealed diffuse bone pain on palpation. Laboratory testing revealed anemia at 9 g/dl, high serum viscosity (80 mm/h). C reactive protein at 100 mg/l. Serum protein electrophoresis showed monoclonal spike (30 g/dL) in the gamma zone. Serum immunofixation study revealed a IgG lambda monoclonal paraprotein. Serum free light chains (kappa/lambda ratio: 0,04). Total protein level (88g/L). 24-h proteinuria was negative, complete metabolic panel, blood calcium and serum creatinine were normal. Bone marrow aspiration was performed and showed mature and dystrophic plasma cells at 38 %. CT scan of the chest revealed left broncho pulmonary focus associated to a sternal fracture (A), mediastinal tissue mass of superior and posterior mediastinum of 30mm diameter (B), scanner-guided biopsy confirmed plasmocytoma, bronchoscopy with biopsy which objectified an inflammatory lesion. Hematological assessment concluded to mediastinal plasmocytoma with multiple myeloma Ig G Lambda. The Revised International Staging System is at 2. The patient received empirical antimicrobial therapy with good response, then she was treated with VTD protocol (Bortezomib, thalidomide and dexamethasone), achieving complete remission followed by autologous stem cell transplantation (C,D). Consolidation therapy and maintenance are planned to maintain remission.
Corresponding author
Nouama Bouanani, Hematology and Stem Cell Transplant Department, Blood Transfusion and Cellular Therapy, Cheikh Khalifa International University Hospital, Casablanca, Morocco (nouama2009@hotmail.fr)

This image

Articles published in PAMJ-CM are Open Access and distributed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0).

eISSN: 2707-2797


The PAMJ Clinical Medicine (ISSN: 2707-2797) is a subsidiary of the Pan African Medical Journal. The contents of this journal is intended exclusively for professionals in the medical, paramedical and public health and other health sectors.

Currently tracked by: DOAJ, AIM, Google Scholar, AJOL, EBSCO, Scopus, Embase, IC, HINARI, Global Health, PubMed Central, PubMed/Medline, ESCI

Physical address: Kenya: 3rd Floor, Park Suite Building, Parkland Road, Nairobi. PoBox 38583-00100, tel: +254 (0)20-520-4356 | Cameroon: Immeuble TechnoPark Essos, Yaounde, PoBox: 10020 Yaounde, tel: +237 (0)24-309-5880