An extended stored procedure is a function within a DLL (written in a programming language like C, C++ using Open Data Services (ODS) API) that can be called from T-SQL, just the way we call normal stored procedures using the EXEC statement. See books online to learn how to create extended stored procedures and how to add them to SQL Server.
Yes, you can instantiate a COM (written in languages like VB, VC++) object from T-SQL by using sp_OACreate stored procedure. Also see books online for sp_OAMethod, sp_OAGetProperty,
sp_OASetProperty, sp_OADestroy.