胸骨孤立性浆细胞瘤1例并文献复习

Solitary plasmacytoma of the sternum:a case report and literature review

目的 通过临床病例及文献复习,探讨胸骨孤立性浆细胞瘤(SP)临床诊断与治疗关键问题。方法 分析武汉科技大学附属汉阳医院胸外科2020年9月至2021年10月治疗的1例胸骨SP病人的临床资料(临床表现、实验室特征、影像学特征、外科手术、病理学特征及随访资料),并复习相关文献。结果 计算机体层成像(CT)示胸骨体可见肿块影,呈膨胀性生长,并伴有骨质破坏,边缘较清,周围软组织未见异常改变。术后病理提示胸骨浆细胞瘤,结合血红蛋白、尿本周蛋白、血钙、肌酐水平、免疫球蛋白、骨髓细胞学及X线等,临床诊断为胸骨SP。结论 诊断胸骨SP需综合分析影像学、实验室、病理检查结果及临床表现,尽早明确诊断是关键;手术结合适当的放疗是其治疗的最佳手段。

Objective By reviewing literature of clinical cases,the key problems of clinical diagnosis and treatment of solitary plasmacytoma(SP)of the sternum were discussed.Methods The clinical data(clinical manifestations,laboratory features,imaging features,surgical,pathological features and follow-up data)of a patient with sternal SP treated in the Department of Thoracic Surgery,Hanyang Hospital Affiliated to Wuhan University of Science and Technology from September 2020 to October 2021 were analyzed,and the relevant literature was reviewed.Results Computer tomography(CT)showed a swelling shadow in the sternum body,with a clear margin and no abnormal changes in surrounding soft tissues.Postoperative pathology indicated sternal plasma cell tumor,which was clinically diagnosed as sternal SP,combined with hemoglobin,urinary week protein,serum calcium,creatinine levels,immunoglobulin,bone marrow cytology and X-ray.Conclusion Early diagnosis is the key.The diagnosis of sternum SP requires comprehensive analysis of imaging,laboratory,pathological and clinical findings.Surgery combined with appropriate radiotherapy is the best treatment.