Solitary plasmacytoma

Case contributed by Andrei Tsoriev
Diagnosis certain

Presentation

Patient complains on feeling of fatigue in his neck while talking long.

Patient Data

Age: 50 years old
Gender: Male
mri

Avidly enhancing C6 vertebral body lesion with typical imaging appearance of "mini brain" consisting of intermittent soft tissue and trabeculae. 

Case Discussion

Patients with solitary plasmacytoma in the spine frequently require a biopsy for diagnosis of their condition. This is an appearance of plasmacytoma in the spine, which is sufficiently pathognomonic to obviate biopsy. Identification of a “mini brain” in an expansile lesion in the spine is characteristic of plasmacytoma. It is important that radiologists note this characteristic because biopsy can be avoided in patients with this appearance. Although biopsy might still be required at many institutions, at some institutions surgeons find this appearance sufficiently pathognomonic to bypass biopsy and start treatment.

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