Solitary plasmacytoma of bone (SPB) is a localized, biopsy-proven proliferation of monoclonal plasma cells with no other bone lesions (by MRI and CT scan). Additionally, no other abnormalities attributable to a clonal plasma cell disorder are identified (ie, no hypercalcemia, renal insufficiency, anemia, or multiple bone lesions). If clonal plasma cells are identified in the bone marrow but are less than 10% of the cellularity, a diagnosis of "solitary plasmacytoma with minimal bone marrow involvement" may be made. However, if more than 10% clonal plasma cells are found on bone marrow biopsy, a diagnosis of plasma cell myeloma is appropriate.
SPB makes up 1%-2% of plasma cell neoplasms and occurs more commonly in men, with a median age at diagnosis of 55 years. It is very rare under the age of 30.
Patients present with bone pain or pathologic fracture. If a vertebra is involved, spinal cord compression and associated symptoms may occur. Rarely, patients may present with a palpable mass involving surrounding soft tissue.
Solitary plasmacytoma of bone
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Synopsis

Codes
ICD10CM:
C90.30 – Solitary plasmacytoma not having achieved remission
SNOMEDCT:
10639003 – Solitary plasmacytoma of bone
C90.30 – Solitary plasmacytoma not having achieved remission
SNOMEDCT:
10639003 – Solitary plasmacytoma of bone
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Plasma cell neoplasm or multiple myeloma
- POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, multiple myeloma, and skin changes)
- Osteosarcoma
- Ewing sarcoma
- Osteomyelitis
- Amyloidoma
- Metastatic lesion to bone of solid primary tumor
- Infiltrative bone disease such as histiocytosis
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References
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Last Reviewed:09/09/2018
Last Updated:09/09/2018
Last Updated:09/09/2018