PMC6388956_01
The manifestations of chest CT.. Notes: (A) Chest CT on admission showed a soft tissue mass in the trachea. (B) Chest CT after radiotherapy showed that the lesion disappeared completely.. Abbreviation: CT, computed tomography.
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Chest computed tomography (CT) showed a soft tissue mass in the trachea (Figure 1A). At the end of radiotherapy, the patient's repeated CT (Figure 1B) and laryngoscopy demonstrated that the original lesions had disappeared, but two adjacent smooth neoplasms were observed on the back of the soft palate (Figure 6B).
The bronchoscopic manifestations of the lesion.. Notes: (A) Bronchoscopy revealed two nodular masses with pedicles arising from the posterior wall of the trachea, occluding ~95% of the tracheal lumen. (B) At the end of 14-month follow-up, repeated bronchoscopy revealed complete recovery of the lesion.
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Bronchoscopy revealed two nodular masses with pedicles arising from the posterior wall of the trachea, occluding ~95% of the tracheal lumen (Figure 2A). In view of the residual postoperative lesion in the trachea and the suspicious lesions in the laryngopharynx, the patient was managed with radiotherapy at a dose of 48 Gy over 4 weeks (Figure 2B).
The size of the excised tumor.. Notes: (A) The long axis was 2.3 cm. (B) The short axis was 1.5 cm.
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The excised tumor measured 2.3x1.5 cm in diameter (Figure 3), and the patient's respiratory symptoms were relieved significantly.
Histopathology of the tumor.. Notes: (A) The plasma cells are relatively uniform and most have eccentrically located nuclei (H&E, 400x). (B) The nuclear chromatin is dispersed, and a prominent centrally located nucleolus can be found in each nucleus (H&E, 400x). Immunohistochemical staining showed (C) expression of CD38, (D) absence of CD20, (E) cytoplasmic lambda light chain positivity, and (F) absence of kappa light chain expression. (G) The MIB-1 (Ki67) index is ~10%.
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Pathological examination with immunohistochemical staining diagnosed the mass as plasmacytoma (Figure 4).
The manifestation of 18FDG-PET/CT.. Note: 18FDG-PET/CT showed localized and increased FDG uptake within the anterior and posterior walls of the laryngopharynx.. Abbreviation: 18FDG-PET/CT, 18-fluorodeoxyglucose positron emission tomography.
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For a more comprehensive examination, the patient underwent an 18-fluorodeoxyglucose positron emission tomography (18FDG-PET/CT) imaging scan, which showed localized and increased FDG uptake within the anterior and posterior walls of the laryngopharynx (Figure 5), with no abnormalities in the bone or other tissues.
The laryngoscopic manifestations of the tumor.. Notes: (A) Laryngoscopy showed multiple nodules located in the laryngopharynx. (B) Laryngoscopy after radiotherapy showed two adjacent smooth neoplasms on the back of the soft palate.
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Laryngoscopy was done (Figure 6A), and histopathology of the laryngeal biopsies showed that many submucosal masses of plasma cells proliferated. At the end of radiotherapy, the patient's repeated CT (Figure 1B) and laryngoscopy demonstrated that the original lesions had disappeared, but two adjacent smooth neoplasms were observed on the back of the soft palate (Figure 6B).
Enhanced MRI of laryngopharynx.. Notes: (A) MRI of the nasopharynx showed a round tumor located in the mucosa of the left oropharynx, ~7 mm in diameter, that had homogeneous signal intensity similar to the signal intensity of the mucosa on T1-weighted imaging and was enhanced with contrast. (B) On T2-weighted imaging, the signal intensity of the tumor was moderately higher than that of the mucosa.
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MRI showed the tumor located in the mucosa of the left oropharynx, which was ~7 mm in diameter (Figure 7).