PMC6503795_01
Extraoral examination revealing facial asymmetry on the right side of the face
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F1
On inspection, a solitary, diffuse swelling over the middle-third region of the face was noticed [Figure 1].
Intraoral examination revealing a well-defined solitary erythematous growth in the right retromolar region
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F2
Intraoral examination [Figure 2] revealed a well-defined solitary erythematous growth in the right retromolar region at the previous extraction site.
Orthopantamograph revealing ill-defined radiolucency encompassing the entire right side of the mandible
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F3
Orthopantamograph [Figure 3] revealed ill-defined radiolucency encompassing entire right side of the mandible extending posteriorly from 47 to ramus, angle, coronoid and condylar process.
Reconstructed computed tomography scan revealing large expansile lytic on the right posterior mandible region (a) Completely resorbed Medial aspect of the ramus with alveolar erosion(b)
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F4
Reconstructed computed tomography scan revealed large expansile lytic lesion with irregular borders on the right posterior mandible region [Figure 4a]. Medial aspect of the ramus was completely resorbed [Figure 4b].
Photomicrograph showing solid sheets of plasma cells (a) and also anaplastic cells with occasional binucleated forms (b)
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F5
Histopathology revealed solid sheets of densely packed, uniformly appearing round-to-ovoid cells with eccentrically placed nucleus resembling plasma cells [Figure 5a]. Anaplastic cells with hyperchromatic nucleus and occasional binucleated forms [Figure 5b] suggesting malignancy were also observed.
Immunohistochemistry showing strong positivity for CD138 (a), MUM1 (b), variable cell membrane positivity for CD45 (c) and negativity for CD20 (d)
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F6
Based on laboratory findings, the final diagnosis of solitary plasmacytoma of the mandible was given which was then confirmed by immunohistochemistry which revealed strong positivity for CD138 [Figure 6a], MUM1 [Figure 6b], variable cell membrane positivity for CD45 [Figure 6c] and negativity for CD20 [Figure 6d].