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Click 66-year-old male with extramedullary duodenal plasmacytoma. Contrast enhanced (IV and oral) CT scan of the abdomen and pelvis obtained in the axial and coronal planes shows: 1. Large soft tissue mass which appears to arise from the descending portion of the duodenum with associated extensive intrahepatic and extrahepatic biliary ductal dilatation and mesenteric lymphadenopathy. 2. Numerous lytic lesions throughout the ribs, multilevel vertebral bodies, and pelvis. 3. Left paraspinal soft tissue mass adjacent to T-10 vertebral body. 4. Cholelithiasis. [Technique: KVp = 120; mA = 356; Slice Thickness = 4.00 mm; Dose of intravenous contrast: Iopamidol (Isovue-300), 100 ml].

Click 66-year-old male with extramedullary duodenal plasmacytoma. Three-dimensional Radial MRCP Breath Hold images showing: 1. Significant intra- and extrahepatic biliary ductal dilatation. 2. Main pancreatic duct dilatation. 3. Large, non-cystic, space occupying mass impinging on the duodenal lumen. 4. Cholelithiasis.

Click 66-year-old male with extramedullary duodenal plasmacytoma. Transverse noncontrast, T1-weighted, 2D fat-suppressed spoiled gradient-echo images demonstrating: 1. The duodenal tumor that demonstrates homogenous signal intensity, isointense to the paraspinal muscles. 2. Multiple vertebral lesions. 3. A 2.3 x 1.2 cm left paraspinal lesion adjacent to the 10th vertebral body, isointense to the paraspinal muscles. 4. Large gallstone.

Click 66-year-old male with extramedullary duodenal plasmacytoma. Transverse noncontrast, T2-weighted, fat-suppressed image, fat-suppressed images demonstrating: 1. The duodenal tumor that demonstrates homogenous high signal intensity compared to the paraspinal muscles. 2. Multiple vertebral lesions showing high T2 signal intensity. 3. A 2.3 x 1.2 cm hyperintense left paraspinal lesion adjacent to the 10th vertebral body. 4. Intrahepatic and extrahepatic biliary ductal dilatation and pancreatic duct dilatation. 5. Large gallstone.

Click 66-year-old male with extramedullary duodenal plasmacytoma. Transverse, T1-weighted, fast-suppressed, 3D spoiled gradient echo (LAVA) sequences, before and after intravenous contrast (20 ml gadobenate dimeglumine, Multihance) demonstrating: 1. Duodenal tumor showing mild enhancement during the hepatic arterial-dominant phase, becomes homogenous with higher enhancement after one minute, and two-minute delay. 2. Multiple, enhancing, vertebral lesions. 3. A 2.3 x 1.2 cm, enhancing, left paraspinal lesion adjacent to the 10th vertebral body. 4. Intrahepatic and extrahepatic biliary ductal dilatation and pancreatic duct dilatation. 5. Large gallstone.

Click 66-year-old male with extramedullary duodenal plasmacytoma. Transverse, T1-weighted, fast-suppressed, 3D spoiled gradient echo (LAVA) sequences, before and after intravenous contrast (20 ml gadobenate dimeglumine, Multihance) demonstrating: 1. Duodenal tumor showing mild enhancement during the hepatic arterial-dominant phase, becomes homogenous with higher enhancement after one minute, and two-minute delay. 2. Multiple, enhancing, vertebral lesions. 3. A 2.3 x 1.2 cm, enhancing, left paraspinal lesion adjacent to the 10th vertebral body. 4. Intrahepatic and extrahepatic biliary ductal dilatation and pancreatic duct dilatation. 5. Large gallstone.

Click 66-year-old male with extramedullary duodenal plasmacytoma. Transverse, T1-weighted, fast-suppressed, 3D spoiled gradient echo (LAVA) sequences, before and after intravenous contrast (20 ml gadobenate dimeglumine, Multihance) demonstrating: 1. Duodenal tumor showing mild enhancement during the hepatic arterial-dominant phase, becomes homogenous with higher enhancement after one minute, and two-minute delay. 2. Multiple, enhancing, vertebral lesions. 3. A 2.3 x 1.2 cm, enhancing, left paraspinal lesion adjacent to the 10th vertebral body. 4. Intrahepatic and extrahepatic biliary ductal dilatation and pancreatic duct dilatation. 5. Large gallstone.

Click 66-year-old male with extramedullary duodenal plasmacytoma. Transverse, T1-weighted, fast-suppressed, 3D spoiled gradient echo (LAVA) sequences, before and after intravenous contrast (20 ml gadobenate dimeglumine, Multihance) demonstrating: 1. Duodenal tumor showing mild enhancement during the hepatic arterial-dominant phase, becomes homogenous with higher enhancement after one minute, and two-minute delay. 2. Multiple, enhancing, vertebral lesions. 3. A 2.3 x 1.2 cm, enhancing, left paraspinal lesion adjacent to the 10th vertebral body. 4. Intrahepatic and extrahepatic biliary ductal dilatation and pancreatic duct dilatation. 5. Large gallstone.

Click 66-year-old male with extramedullary duodenal plasmacytoma. Contrast enhanced (IV and oral) CT scan of the abdomen and pelvis obtained in the axial and coronal planes, six weeks following chemotherapy, shows: 1. Interval resolution of the duodenal soft tissue tumor; there remains minimal circumferential duodenal wall thickening. 2. Biliary stent, with some residual biliary ductal dilatation. 3. Interval resolution of the left paraspinal soft tissue mass adjacent to T-10 vertebral body.