Biliary obstruction secondary to an extramedullary plasmacytoma of the pancreas: confusion with pancreatitis on computed tomography.

A 29-year-old woman with a history of a maxillary plasmacytoma treated with radiation therapy presented with painless jaundice. A computed tomography (CT) scan revealed biliary dilatation and diffuse pancreatic enlargement suggestive of pancreatitis. Percutaneous transhepatic cholangiography demonstrated encasement of the distal common bile duct by an extrinsic mass. At exploratory laparotomy, a large mass replacing the entire pancreas was found. Pathologic examination confirmed plasmacytoma. This report presents a unique case of extramedullary plasmacytoma involving the pancreas early in a patient's clinical course. The CT appearance was similar to that of acute pancreatitis.