Extramedullary plasmacytoma: clinicopathology, immunohistochemistry and therapeutic approach to a case with a tonsillar site.

Hematol Oncol Stem Cell Ther 1(4) October 2008 hemoncstem.edmgr.com 241 Monoclonal extramedullary plasmacytoma (EMP) is a rare plasma cell tumor. The dil agnosis is based on a mass of clonal plasma cells separate from bone or bone marrow without evil dence of occult disease elsewhere. It occurs in the upper aerodigestive tract in more than 80% of patients, most often in the nasal cavity, paranasal sinuses, nasopharynx, oropharynx and larynx.1,2 Regional nodes are invaded in less than 10% of patients.1 The disease is more coml mon in males with a peak incidence in the sixth decade. Primary EMP often presents with a mass and produces local compressive symptoms. The differential diagnosis includes benign reactive processes, carcinoma and lyml phoma. Radiotherapy (RT) is an effective modality of treatment for EMP with high local control rates (85% to 100%).1,3l6 Currently moderate dose RT (40l50 Gy) using involved fields is recommended.