Walking the Risk-Benefit Tight Rope: A Case of Post Fine Needle Aspiration Haemorrhage in Extramedullary Plasmacytoma.

BACKGROUND

Primary extramedullary plasmacytomas (EMP) are rare, however secondary forms may be seen in ~10-15% patients with systemic multiple myeloma (MM). The diagnosis of EMP is based on demonstration of monoclonal plasma cells in the lesion, which requires tissue sampling.

CASE PRESENTATION

We present a case of a 38 year old female with MM, who underwent diagnostic US at our institute. Multiple focal liver lesions were detected, which were suspicious for EMP. She underwent fine needle aspiration cytology (FNAC) for diagnosis, following which she developed hemoperitoneum secondary to deranged clotting parameters (prothrombin time and platelet count). CT Angiography revealed active hepatic capsular bleed. She was taken up for percutaneous embolisation, and the supplying vessel successfully embolised using gelfoam particles. Complications may rarely occur in interventional procedures, particularly in patients with comorbidities. However, prompt diagnosis and management help prevent adverse outcomes.