颌面部髓外浆细胞瘤

髓外浆细胞瘤为少见疾病,发生在颌面部软组织者更少见。本文结合一典型病例的临床诊治过程,分析研究其发病原因,临床及病理分型和诊断方面存在的问题。提出颌面部髓外浆细胞瘤良性及恶性其主要临床特征和有关的诊断依据。治疗仍多采用综合方法。恶性者放疗总剂量多在5000Gy以上,化疗以COP,COAP、COAAP方案为主,散在病损可行激光治疗效果良好。     

Intracranial plasmacytoma: a case report

Multiple myeloma may have extraosseous manifestations in the cranial region. It may be a solitary intracranial tumour without any other signs of multiple myeloma, or intracranial disease may be a part of generalised disease, as in the present case. Our patient had received chemotherapy for multiple myeloma for 9 months, with good response. However, her condition suddenly deteriorated, with signs of increased intracranial pressure and a 5-cm-diameter tumour infiltrating the meninges and brain was found in the left temporal fossa. The radiological diagnosis, based on contrast-enhanced CT and angiography, was not straightforward or specific for plasmacytoma, as chemotherapy for the extracranial disease had been successful. Diseases such as meningioma, metastasis, lymphoma, chondrosarcoma or haemangioma had to be considered. Received: 1 November 1994 Accepted: 31 August 1995     

Fine-needle aspiration of pancreatic extramedullary plasmacytoma: Possible confusion with islet cell tumor

We report two cases of extramedullary plasmacytoma (EMP) of the pancreas, diagnosed by fine-needle aspiration (FNA). Plasmacytoma of the pancreas is a rare neoplasm with only 12 cases recorded in the literature. Because of its scarcity and the cytomorphologic similarity between plasma cells and endocrine cells, EMP of the pancreas may be confused with neuroendocrine (islet cell) tumors of the pancreas. Immunohistochemical staining for light chain and/or neuroendocrine markers will prevent diagnostic error when interpreting plasmacytoid neoplasms of any site susceptible to endocrine tumors, including the pancreas. © 1994 Wiley-Liss, Inc.     

IgG-KAPPA-PRODUCING PRIMARY PLASMACYTOMA OF THE THYROID GLAND WITH PREOPERATIVE SERUM M PROTEIN

A case of primary plasmacytoma of the thyroid gland which occurred in a 63-year-old woman is reported. Histologic and ultramicroscopic examination revealed that the excised thyroid tumor was plasmacytoma superimposed on lymphocytic thyroiditis. Immunohistological study showed that the tumor cells produced intracytoplasmic immunoglobulin (IgG-kappa). Electropho-retic and immunoelectrophoretic studies disclosed the presence of monoclonal immunoglobulin (IgG-kappa) in samples of the patient's serum which had been obtained preoperatively. After completion of irradiation therapy to the neck following tumor removal, the serum monoclonal immunoglobulin disappeared. The patient is currently alive and well without any evidence of the tumor three years after surgery.     

Leptomeningeal myelomatosis mimicking a subdural haematoma

We report a rare appearance at presentation of meningeal myelomatosis without bone involvement, in the form of an extra-axial mass of mixed density, resembling a chronic subdural haematoma. Received: 24 September 1999/Accepted: 12 January 2000     

原发性肺浆细胞瘤(附1例报告)

目的 了解原发性肺浆细胞瘤的临床表现、病理表现及诊治。方法 1例左上肺孤立型病灶患者，行经皮肺穿刺活检和开胸探查术，结合有关文献及本例患者的临床资料，对本病的临床表现、病理表现及诊治进行论述。结果 本病的病理表现主要为表现为弥漫性浸润的浆细胞聚集，呈嗜碱性或嗜酸性，染色质粗，核质成熟不同步，免疫组化浆细胞为单克隆的。结论 原发性肺浆细胞瘤是一种极为罕见的肿瘤，病理检查和免疫组化可确诊。     

孤立性膀胱浆细胞瘤的病例分析及文献复习

目的探讨孤立性膀胱浆细胞瘤的临床表现、诊断与治疗。方法回顾分析我院于20l9年5月10日收治的1例膀胱浆细胞瘤患者的临床病理特征资料、诊疗过程、随访情况,总结现有文献讨论并总结本病诊治心得。结果51岁女性,因尿急尿痛入院。术前CT增强考虑肿瘤性病变,未除外膀胱癌,行膀胱镜检查+经尿道膀胱肿瘤电切术。术后病理提示为黏膜固有层内见大小一致的肿瘤细胞弥漫浸润,核偏位,呈浆细胞样,核分裂象罕见,高度疑为浆细胞瘤。免疫组化染色:Ki67(2%+),CD38(+),CD138(+),Kappa(+),Lambda(–)。术后予行进一步放疗(50Gy/25F),7个月后复查未见肿瘤复发及转移。结论膀胱浆细胞瘤临床上极其罕见,无特征性临床表现,治疗推荐选用根治性放疗联合手术切除;另外,血液科、放疗科和外科医师间的紧密协作对于制定合适的治疗方案至关重要。     

Testicular plasmacytoma with bone dissemination without medullary plasmacytosis

A 34-year-old man was diagnosed as having solitary testicular plasmacytoma. He had received palliative radiotherapy, several combined chemotherapies including CHOP chemotherapy (vincristine, cyclophosphamide, Adriamycin, and prednisone), MP (melphalan and prednisone) and M-2 protocol (melphalan, prednisone, vincristine, carmustine, and cyclophosphamide), and interferon therapy as 3 million units subcutaneous injection three times a week for 1 year. Extensive bone plasmacytoma developed 7 years later without bone marrow involvement. We suggest that early use of combined chemoradiotherapy and high-dose chemotherapy with autologous stem cell support should be investigated in patients with testicular plasmacytoma with dissemination.     

Infiltrating ductal breast carcinoma with monoclonal gammopathy of undetermined significance: A case report

BACKGROUNDInfiltrating ductal breast carcinoma with monoclonal gammopathy of undetermined significance (MGUS) is rare and easily misdiagnosed. Most patients are first diagnosed with MGUS. We report a rare case of MGUS secondary to infiltrating ductal breast carcinoma. We also review the literature to analyze the clinical characteristics and diagnostic methods.CASE SUMMARYA 51-year-old woman underwent modified radical mastectomy for infiltrating ductal carcinoma of the right breast and was then treated with radiation and chemotherapy. A decreased platelet count was found on routine blood examination, and MGUS was subsequently diagnosed. This is the first report of the occurrence of MGUS after breast cancer surgery.CONCLUSIONVigilance is required to distinguish this rare comorbidity from breast plasmacytoma.