孤立性浆细胞瘤18例临床病理观察

The clinicopathological study of 18 solitary plasmacytoma patients

目的 探讨孤立性浆细胞瘤的诊断、鉴别诊断、治疗和预后,总结其临床特点,提高病理及临床的诊治水平.方法 收集18例浆细胞瘤的临床资料并对其临床特点、诊断标准及治疗和预后做回顾性分析.结果 所有病例均经病理证实为孤立性浆细胞瘤并符合孤立性浆细胞瘤的诊断标准.18例孤立性浆细胞瘤中,男12例,女6例,发病部位分别为腰椎4例,下颌骨及肋骨各2例,骶骨及枕骨各1例,鼻腔及上颌窦3例,鼻咽部2例,腮腺、胸骨旁及腹腔各1例.所有病例平均随访54个月,2例死亡,3例局部复发,2例转变为多发性骨髓瘤,余者经放疗及化疗后均无瘤生存.结论 尽早明确诊断是治疗的关键,免疫组织化学染色CD798和CD138具有较高的特异性.手术结合适当的放疗和化疗是其治疗的最佳手段.

Objective To investigate the diagnosis,differential diagnosis,treatment and prognosis of solitary plasmacytoma （SP） and summarize its clinical features for pathological and clinical application.Methods Reviewed the data of 18 patients diagnosed with SP from January 2005 to August 2013.The clinical features,diagnosis,treatment and prognosis were analyzed retrospectively.Results All 18 cases were pathologically confirmed with SP and met the diagnostic criteria of SP.In 18 patients,12 patients were male and 6 patients were female.Four cases of lesion were located at lumbar,each 2 cases of lesion were located at mandible and ribs,each 1 case of lesion was located at sacrum and occipital bone,3 cases of lesion were located at nasal cavity and maxillary sinus,2 cases of lesion was located at pars nasalis pharyngis,each 1 case of lesion was located at parotid,parasternal and peritoneal cavity.All patients were followed up for 54 months,2 patients were died,3 patients were local recurrence,2 patients were transformed to multiple myeloma,others were survival with no tumor.Conclusions As early as possible to diagnose is the key to treat SP.The final diagnosis of SP is based on the histopathological findings and the optimal treatment for patients with SP is surgery combined with moderate dose radiotherapy.