眼眶髓外浆细胞瘤的诊断和治疗

目的探讨眼眶髓外浆细胞瘤(EMP)的临床特点、诊断及治疗方法。设计回顾性病例系列。研究对象EMP患者4例。方法回顾分析我院2003年7月～2005年12月间收治的4例EMP患者的资料,分析其临床特点、病理诊断分型。4例患者均行手术加辅助放射治疗。主要指标EMP的临床特点、病理诊断及治疗方法。结果临床主要表现为眼球突出和局部肿物及其引起的相应症状。4例均行手术切除肿物,病理诊断为髓外浆细胞瘤。免疫组化检测,2例κ型,2例λ型,3例浆细胞抗体阳性。4例尿本周蛋白均为阴性。2例骨髓穿刺均未见异常。4例胸部经X线检查均正常。术后平均随访24个月,均无局部复发、远处转移。结论EMP的诊断主要依靠临床表现和病理并经系统检查除外多发性骨髓瘤。手术和放射治疗是EMP的主要治疗手段。

Diagnosis and treatment of orbit extramedullary plasmacytoma

Objective To evaluate clinical feature, diagnosis, and treatment of extrameduUary plasmacytoma (EMP) in the orbit. Design Retrospective case series. Participants 4 patients with EMP. Methods Clinical data of 4 patients with pathologically confirmed EMP in the orbit, treated in our hospital from July 2003 to December 2005 were reviewed. All of the patients underwent surgery plus adjuvant radiotherapy. Main Outcome Measures The clinical features, diagnosis and treatment of orbital EMP. Results The patients manifested mainly as exophthalmos, local masses and relevant symptoms. All of the patients received immunohistochemical staining, 2 were k type, and 2 were type. The plasma cell antibody of 3 patients showed masculine results. Four patients received Bence-Jones protein detection, all of them showed negative results. Bone marrow biopsy was made in 2 patients, and X ray film of chest survey was made in 4 patients, all results were normal. By the end of follow-up (June, 2006), there were no local recurrence and distant metastasis during average follow-up 24 months. Conclusion The diagnosis of EMP depends mainly on clinical manifestation and pathologic results and exclusion of multiple myeloma (MM). Surgery and radiotherapy are the main treatment for EMP in the orbit.