Plasma cell myeloma infiltrating the dental pulp: An interesting finding
A 55-year-old male patient reported to our department with complaints of pain and numbness on the right side of mandible of 3 months duration. His medical history revealed that he was under treatment for PCM, which was diagnosed a year back (M-band positive in protein immunoelectrophoresis). Radiographs showed multiple punched out radiolucencies on skull and spinal X-rays [Figure and ].\nOn examination there was a diffuse swelling on the right side of mandibular body seen in relation to 45, 46 and 47 regions. Mucosa over the swelling was normal. It was bony hard on palpation with slight buccal and lingual cortical expansion. The right molar (46) was caries exposed with grade III mobility []. Radiograph showed altered trabecular pattern in the periapical region of 46 []. The teeth was extracted and tissue from the adjoining socket area was reviewed for microscopic examination.\nHistopathologically, the tissue showed proliferating sheets of atypical plasma cells. Most of the cells had an abundant basophilic cytoplasm and an eccentrically placed nucleus. In between these cells were cells with centrally placed nuclei and basophilic cytoplasm, the plasmablasts. Prominent nucleoli were also seen [Figure and ].\nThe pulpal cavity of the extracted 46 after decalcification and hematoxylin and eosin (H and E) staining showed infiltration with atypical plasma cells with eccentrically situated nuclei and mild degree of nuclear pleomorphism [Figure –]. Immunohistochemical staining (IHC) for kappa and lambda light chains were done. The plasma cells showed strong cytoplasmic positivity for kappa-stain and were negative for lambda light chain which is consistent with clonal plasma cell dyscrasia [Figure and ].