Epibulbar Plasmacytoma Masquerading as Subconjunctival Hemorrhage in a Patient with Multiple Myeloma

Amanda Bradley, Amy Estes, Lane Ulrich, Dilip Thomas, David Gay

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: We report a 75-year-old woman with a history of multiple myeloma immunoglobulin D (IgD) variant, who presented with an epibulbar plasmacytoma masquerading as a subconjunctival hemorrhage. Methods: Magnetic resonance imaging of the brain and orbits with and without contrast was obtained and surgical biopsy of the subconjunctival lesion was performed; histopathology confirmed the diagnosis of plasmacytoma. Results: Subconjunctival biopsy revealed a plasma cell neoplasm infiltrate in the episcleral layer. The subconjunctival biopsy stained positive for CD138 and lambda-immunohistochemistry in the majority of plasma cells. Histologic findings were consistent with involvement by known IgD plasma cell myeloma where previous bone marrow biopsy demonstrated myeloma cells which stained monoclonally for IgD-lambda light chains. Conclusions: Although plasma cell neoplasms seldom present with ocular manifestations, it is crucial to recognize that these tumors may be associated with multiple myeloma. In patients with known multiple myeloma who present with subconjunctival hemorrhage, close follow-up is highly recommended, as this may be the initial presentation of an ocular plasmacytoma. Although a plasmacytoma is a rare subconjunctival lesion, it should not be immediately excluded from the differential diagnosis of such lesions.

Original languageEnglish (US)
Pages (from-to)249-251
Number of pages3
JournalCornea
Volume36
Issue number2
DOIs
StatePublished - Feb 1 2017

Fingerprint

Plasmacytoma
Multiple Myeloma
Immunoglobulin D
Plasma Cell Neoplasms
Hemorrhage
Biopsy
Eye Manifestations
Somatostatin-Secreting Cells
Orbit
Plasma Cells
Differential Diagnosis
Bone Marrow
Immunohistochemistry
Magnetic Resonance Imaging
Light
Brain
Neoplasms

Keywords

  • multiple myeloma
  • plasmacytoma
  • subconjunctival hemorrhage

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Epibulbar Plasmacytoma Masquerading as Subconjunctival Hemorrhage in a Patient with Multiple Myeloma. / Bradley, Amanda; Estes, Amy; Ulrich, Lane; Thomas, Dilip; Gay, David.

In: Cornea, Vol. 36, No. 2, 01.02.2017, p. 249-251.

Research output: Contribution to journalArticle

@article{eeaa4af5f7cd4a8da758a0714c2bebc0,
title = "Epibulbar Plasmacytoma Masquerading as Subconjunctival Hemorrhage in a Patient with Multiple Myeloma",
abstract = "Purpose: We report a 75-year-old woman with a history of multiple myeloma immunoglobulin D (IgD) variant, who presented with an epibulbar plasmacytoma masquerading as a subconjunctival hemorrhage. Methods: Magnetic resonance imaging of the brain and orbits with and without contrast was obtained and surgical biopsy of the subconjunctival lesion was performed; histopathology confirmed the diagnosis of plasmacytoma. Results: Subconjunctival biopsy revealed a plasma cell neoplasm infiltrate in the episcleral layer. The subconjunctival biopsy stained positive for CD138 and lambda-immunohistochemistry in the majority of plasma cells. Histologic findings were consistent with involvement by known IgD plasma cell myeloma where previous bone marrow biopsy demonstrated myeloma cells which stained monoclonally for IgD-lambda light chains. Conclusions: Although plasma cell neoplasms seldom present with ocular manifestations, it is crucial to recognize that these tumors may be associated with multiple myeloma. In patients with known multiple myeloma who present with subconjunctival hemorrhage, close follow-up is highly recommended, as this may be the initial presentation of an ocular plasmacytoma. Although a plasmacytoma is a rare subconjunctival lesion, it should not be immediately excluded from the differential diagnosis of such lesions.",
keywords = "multiple myeloma, plasmacytoma, subconjunctival hemorrhage",
author = "Amanda Bradley and Amy Estes and Lane Ulrich and Dilip Thomas and David Gay",
year = "2017",
month = "2",
day = "1",
doi = "10.1097/ICO.0000000000001071",
language = "English (US)",
volume = "36",
pages = "249--251",
journal = "Cornea",
issn = "0277-3740",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Epibulbar Plasmacytoma Masquerading as Subconjunctival Hemorrhage in a Patient with Multiple Myeloma

AU - Bradley, Amanda

AU - Estes, Amy

AU - Ulrich, Lane

AU - Thomas, Dilip

AU - Gay, David

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Purpose: We report a 75-year-old woman with a history of multiple myeloma immunoglobulin D (IgD) variant, who presented with an epibulbar plasmacytoma masquerading as a subconjunctival hemorrhage. Methods: Magnetic resonance imaging of the brain and orbits with and without contrast was obtained and surgical biopsy of the subconjunctival lesion was performed; histopathology confirmed the diagnosis of plasmacytoma. Results: Subconjunctival biopsy revealed a plasma cell neoplasm infiltrate in the episcleral layer. The subconjunctival biopsy stained positive for CD138 and lambda-immunohistochemistry in the majority of plasma cells. Histologic findings were consistent with involvement by known IgD plasma cell myeloma where previous bone marrow biopsy demonstrated myeloma cells which stained monoclonally for IgD-lambda light chains. Conclusions: Although plasma cell neoplasms seldom present with ocular manifestations, it is crucial to recognize that these tumors may be associated with multiple myeloma. In patients with known multiple myeloma who present with subconjunctival hemorrhage, close follow-up is highly recommended, as this may be the initial presentation of an ocular plasmacytoma. Although a plasmacytoma is a rare subconjunctival lesion, it should not be immediately excluded from the differential diagnosis of such lesions.

AB - Purpose: We report a 75-year-old woman with a history of multiple myeloma immunoglobulin D (IgD) variant, who presented with an epibulbar plasmacytoma masquerading as a subconjunctival hemorrhage. Methods: Magnetic resonance imaging of the brain and orbits with and without contrast was obtained and surgical biopsy of the subconjunctival lesion was performed; histopathology confirmed the diagnosis of plasmacytoma. Results: Subconjunctival biopsy revealed a plasma cell neoplasm infiltrate in the episcleral layer. The subconjunctival biopsy stained positive for CD138 and lambda-immunohistochemistry in the majority of plasma cells. Histologic findings were consistent with involvement by known IgD plasma cell myeloma where previous bone marrow biopsy demonstrated myeloma cells which stained monoclonally for IgD-lambda light chains. Conclusions: Although plasma cell neoplasms seldom present with ocular manifestations, it is crucial to recognize that these tumors may be associated with multiple myeloma. In patients with known multiple myeloma who present with subconjunctival hemorrhage, close follow-up is highly recommended, as this may be the initial presentation of an ocular plasmacytoma. Although a plasmacytoma is a rare subconjunctival lesion, it should not be immediately excluded from the differential diagnosis of such lesions.

KW - multiple myeloma

KW - plasmacytoma

KW - subconjunctival hemorrhage

UR - http://www.scopus.com/inward/record.url?scp=84995772601&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84995772601&partnerID=8YFLogxK

U2 - 10.1097/ICO.0000000000001071

DO - 10.1097/ICO.0000000000001071

M3 - Article

C2 - 28060076

AN - SCOPUS:84995772601

VL - 36

SP - 249

EP - 251

JO - Cornea

JF - Cornea

SN - 0277-3740

IS - 2

ER -