胸膜浆细胞瘤1例报道及其临床病理特点分析

Right pleural plasmacytoma:a case report and clinicopathologic analysis

目的:报道1例胸膜浆细胞瘤,结合文献探讨其临床及病理组织学特点。方法:对1例胸膜浆细胞瘤进行常规病理、免疫组化分析。结果:成年男性患者1例,临床表现为右胸部疼痛,胸部CT示右侧胸腔少量积液,右侧侧壁胸膜局限性增厚。镜下可见肿瘤组织由大量密集的多形性浆细胞构成,细胞多为圆或卵圆形,胞浆嗜碱性,核偏心位,染色质呈块状沿核膜排列,状似车轮,有时核旁出现亮晕。免疫组化瘤细胞表达λ链(+++)、Vimentin(+++),CK(-)、LCA(-)、S-100(-)、CA125(-)。结论:原发于纵隔、胸膜的浆细胞瘤十分少见,诊断依赖临床、影像学、病理学三方面结合,需与浆细胞肉芽肿、间变性大细胞淋巴瘤等相鉴别。

Objective ：To study the clinical and pathological features of pleural plasmacytoma. Methods：One case of pleural plasmacytoma was investigated by histopathogical and immunohistochemical observation. Results：A male patient with a symptom of chest pain, on CT of the chest showed less pleural effusion in the right side and localized pleural thickening. Microscopically, the tumor tissue consists of dense polymorphic plasmacyte which were round or oval with basophilous cytoplasma and nucleus asymmetry. In some tumor cells, chromatin arranged aside nuclear membrane. In immunohistochemistry, the tumor cells were positive for λ -link and Vimentin, but negative for CK, LCA ,S- 100 and CA125. Conclusion： Primary plasmacytoma was rare in mediastinum and pleural. Its diagnosis mainly relied on the combination of clinic, imageology and pathology, and it would be differentiated from plasma cell granuloma and large -cell anaplastic lymphoma.