Case 94 – update 1

Our patient has undergone emergency surgical decompression for severe C3/4 spinal cord compression secondary to a lesion in his C3 vertebral body. He is recovering well on the neurosurgical ward.

Initial investigations were unremarkable.

Results update:

Following discussion, the further investigations below were requested and all found to be within their normal ranges:

Serum calcium, immunoglobulins, serum electrophoresis, serum free light chains, beta 2 microglobulin, LDH, HIV, Hepatitis B, Hepatitis C.

Histopathology have called through a provisional report, our patient’s C3 biopsy is ‘highly suspicious for plasmacytoma’.

Questions:

  • What histopathological features would support a diagnosis of plasmacytoma?
  • How would you prioritise further investigations for our patient? Why?
  • How would you explain this result to our patient?

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