Solitary bone plasmacytoma (PET-CT)

Case contributed by Artyom Artashesyan


Patient with right 8th rib expansile lytic lesion, histologically proven plasmacytoma. Comes to PET/CT for initial staging.

Patient Data

Age: 40 years
Gender: Male
Nuclear medicine

There is FDG avid expansile lytic lesion of right 8th posterior rib with SUVmax=16.8. On CT series it shows coarse trabecular pattern with outer cortical thinning and destruction. There are no other high metabolically active lesions associated with plasmacytoma.

Additional findings right humeral head low metabolically active lytic lesion-hemangioma.

Case Discussion

Plasmacytoma is FDG avid tumor which originates from plasma cells. It is divided into two subgroups: the solitary bone plasmacytoma (SBP) commonly localized in axial skeleton, and extramedullary plasmacytoma (EMP).

SBP rarely transforms to multiple myeloma (MM), but more frequently than EMP. 

The role of PET with FDG in SBP is to exclude other sites of the disease and assess the metabolic activity of the initial lesion, which independently correlates with a high risk of transformation into MM.

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