A Rare Case of Solitary Endobronchial Plasmacytoma Presented With Complete Airway Obstruction: A Case Report.

Abstract

This case report presents a rare instance of solitary endobronchial plasmacytoma in a 58-year-old male, who had progressively worsening shortness of breath and a productive cough. The patient, who had a smoking history, was found to have a large, hypervascular mass completely obstructing the right main bronchus, confirmed as a plasma cell tumor via endoscopic biopsy. Further diagnostic imaging, including positron emission tomography-computed tomography (PET-CT) and chest CT, revealed a mass measuring 1.7 cm with abnormal fluorodeoxyglucose (FDG) uptake. The bone marrow biopsy ruled out multiple myeloma. The patient underwent challenging endoscopic debulking of the tumor, although margins were not well defined due to its size. Post-operatively, the patient showed significant symptomatic improvement and was discharged home on post-operative day 4. Two months after the procedure, follow-up with a chest CT scan and bronchoscopy showed no evidence of residual tumor or local recurrence, and the patient reported significant respiratory improvement. The literature review revealed that extramedullary plasmacytoma (EMP) is uncommon and often occurs in the upper aerodigestive tract. The diagnostic workup generally involves histopathological analysis, bronchoscopy, and imaging studies. Treatment is tailored to the patient's condition and the characteristics of the tumor. This case underscores the need for a high index of suspicion and comprehensive diagnostic evaluation of patients presenting with obstructive bronchial mass. Furthermore, it highlights the importance of considering endobronchial plasmacytoma in the differential diagnosis of obstructive bronchial masses and the value of early intervention in achieving favorable outcomes. Regular follow-up is crucial to monitor recurrence and ensure ongoing patient well-being.