Diffuse luminal ulceration resulting from duodenal plasmacytoma - 22/08/11
Doi : 10.1016/j.gie.2006.08.015
| Commentary Extramedullary plasmacytomas (EPs) are malignant monoclonal plasma cell tumors that can be considered an interim step in the evolution of monoclonal gammopathy of unclear significance to multiple myeloma. Indeed, EPs progress to multiple myeloma in 11% to 30% of patients by 10 years. EPs usually affect men in their mid 50s and involve the aerodigestive tracts most frequently, especially in the head and neck regions. GI involvement by EPs is unusual but may affect all areas. The appearance of the duodenal process here is curious and appears like ischemic necrosis, although this was not confirmed by microscopy. There is a known association between multiple myeloma and ischemic enteritis by AL amyloid, which is deposited in blood vessels, thereby occluding the vascular lumen and reducing flow. We don’t see that either, so we are stuck, recognizing again that the subtlety of nature is many times greater than the subtlety of our understanding. Lawrence J. Brandt, MD Associate Editor for Focal Points |
© 2007
American Society for Gastrointestinal Endoscopy. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
Vol 65 - N° 4
P. 707-708 - aprile 2007 Ritorno al numero
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