PRIMARY LYMPH-NODE PLASMACYTOMA (PLASMACY TIC LYMPHOMA) - DIFFERENTIAL-DIAGNOSIS OF NODAL PROLIFERATION OF PLASMA-CELLS

History and clinical findings: A 60-year-old man was found on routine examination to have an enlarged, firm, cervical lymph node. He looked older than his age and his general condition was poor. He had no fever , nocturnal sweating or weight loss. Further examination revealed no h epatosplenomegaly on palpation, but numerous enlarged cervical lymph n odes were palpable. Investigations: Histological investigation of a ce rvical lymph node revealed a marked increase in slightly pleomorphic p lasma cells with monotypic expression of IgM-kappa. Multiple myeloma w as excluded on the basis of histological and cytological findings in t he bone marrow. Serology revealed a mild antibody deficiency syndrome (gamma-globulin, 7.8%) with signs of acute inflammation and an increas e in alpha(2)-globulin. There was no evidence of a monoclonal gammopat hy on electrophoresis. A diagnosis of primary nodal plasmacytoma was m ade. Course: As the patient was asymptomatic at diagnosis he was not g iven chemotherapy. There was no evidence of tumour progression at foll ow-up examination two months later His progress will be monitored clos ely. Conclusion: This patient's history is consistent with the prognos is generally associated with primary nodal plasmacytoma that is much b etter than that of multiple myeloma.