case_images: PMC11731487_01
case_images: Characteristics of diagnosis and changes after treatment from our case.
case_images: gr1.jpg
case_images: PMC11731487_01_gr1.jpg
case_images: fig0001
case_images: PET-CT showed that the hypermetabolic thickening of the bowel wall from the pylorus to the duodenum (SUVmax: 4.2, the maximum thickness 3.1 cm) accompanied with hypermetabolic bilateral adrenal masses (SUVmax: 2.7-3.7, the largest measuring 7.6 cm x 5.3 cm x 10.3 cm) and multiple retroperitoneal masses (SUVmax: 2.2, the largest measuring 1.7 cm x 1.2 cm), hypermetabolic left testicular swelling with hydrocele (Fig. 1A) and no bone or bone marrow involvement. Ultrasound showed a neoplastic lesion (13.0 x 7.85 cm) (Fig. 1C) around the left kidney, and there was no ascites. The pathological diagnosis was EMP (Fig. 1B) with CD38(+), CD138(+), Bob. 1(+), lambda(+)>>kappa(+), CD43(+), CD19(+), BCL2(+), CyclinD1(little+), P53(part+, wild type), Ki-67LI 35 %, IgM(-), CD117(-), CD56(-), CD3(-), CD20(-), CD79a(-), CD5(-), CD10(-), BCL6(-), CD21(-), CD35(-), EBER CISH(-). Flow cytometry showed an abnormal phenotype of tumor cells (CD38+, CD138+, clambda+, BCMA+, CD19 part+, CD45-, CD56-, and CD20-) (Fig. 1E). In September 2021, ultrasound examination revealed a significant reduction in the neoplastic mass (3.7 x 1.6 cm) (Fig. 1D) around the left kidney, and no M protein was detected. Flow cytometry of ascites showed 92.4 % monoclonal abnormal plasma cells with abnormal phenotypes (CD38-, CD138+, clambda, ckappa-, CD19 part+, CD56-, and CD20-) (Fig. 1F).