Plasma-Cell Tumor of the Stomach

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Abstract
Plasma-cell tumors of the stomach are of extremely rare occurrence. As recently as 1943, Hellwig (1) reviewed the literature of the preceding thirty-seven years and found only 127 cases of extramedullary plasmacytoma; of these, 5 involved the gastro-intestinal tract and in only 1 (2) were lesions present in the stomach. Since Hellwig's (1) review, we have found reported 2 cases of plasma-cell tumor of the stomach, and recently we encountered a case of our own. Vasiliu and Popa's case (2), cited by Hellwig, occurred in a female, aged 32, who had a five-year history of dyspepsia and anorexia with abdominal discomfort following meals. X-ray examination revealed stasis of barium at the pylorus. At autopsy a tumor was found involving the stomach, intestine, and lymph nodes locally and in the mediastinum. No mention was made of bone marrow involvement. Due to the widespread lesions, the location of the primary tumor in the stomach has to be considered only as a possibility. The two more recent cases were definitely described as being primary in the stomach. The first was published by Couret (3) in 1946. The patient was a 48-year-old white female complaining of epigastric pain, distention, and “gas” for approximately eight years. A gastric analysis was reported as “unsatisfactory.” X-ray studies revealed a persistent filling defect in the prepyloric region of the stomach. A subtotal gastrectomy with removal of the pylorus was performed. No report is made concerning the urinary Bence-Jones protein, total blood protein, and albuminglobulin ratio; nor is there any mention of bone marrow studies. At first a diagnosis of an inflammatory lesion was made. Following re-exploration, the diagnosis of lymphosarcoma was proposed. The patient expired nineteen days after the second laparotomy. At autopsy the lesion was found to involve the stomach, gastric attachment of the greater omentum and the retroperitoneal spaces, and the diagnosis of plasma-cell tumor of the stomach was established. There was no history of radiation therapy. Schwander et al. (4) reported a case in a 42-year-old colored male. The patient had a history of abdominal discomfort for seven years, with episodes of vomiting. On admission, complete pyloric obstruction was demonstrated roentgenologically. X-ray examination revealed no abnormalities of the long bones. Gastric analysis was negative for free hydrochloric acid. A subtotal gastrectomy was carried out, with removal of an annular mass in the prepyloric region. The patient died fourteen days postoperatively from a pulmonary embolus. The diagnosis of plasmacytoma of the stomach with involvement of the regional lymph nodes was made. There was no report as to the total blood protein, albuminglobulin ratio, urinary Bence-Jones protein, or bone marrow studies. Case Report Our patient was a 63-year-old Negro male, who was admitted Oct.
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