Radiographic Analysis of Plasmablastic Lymphoma and Multiple Myeloma/Plasmacytoma in the Jaws: A Comparative Approach

Objective To comparatively investigate the radiographic features of plasmablastic lymphoma (PBL) and multiple myeloma/plasmacytoma of the jaws by a retrospective cross-sectional study. Materials and methods Sixty-seven panoramic radiographs of patients diagnosed with PBL (27 cases) and multiple myeloma/plasmacytoma (40 cases) were retrospectively retrieved from the files of three Brazilian and South African institutions. The original diagnoses were confirmed, and the panoramic radiographs were standardized for descriptive evaluation by three experts. Clinical data were obtained from the patients' medical files. Results Most PBLs on panoramic radiographs were radiolucent (96%), unilocular (41%), with poorly defined borders (100%); whereas some multiple myeloma/plasmacytoma cases presented with well-defined borders (25%), the majority showed a multilocular (68%) and radiolucent (90%) appearance. Although the ‘punched-out' appearance is characteristic of multiple myeloma/plasmacytoma (58%), it was also observed in four PBL cases (15%). Fifteen of the 27 cases (56%) of PBL had floating teeth, whereas an osteoporotic-like appearance with cortical thinning and disappearance of the mandibular canal was more common among patients with multiple myeloma/plasmacytoma. Conclusion Although these entities share some radiographic characteristics, specific findings such as the punched-out pattern and mandibular canal alterations in MM/plasmacytoma and poorly-defined borders with floating-tooth appearance in PBL may provide useful clues in the differential diagnosis.