鼻咽原发性髓外孤立性浆细胞瘤的临床病理特点.pdf

第31卷第6期
中山大学学报(医学科学版)
Vol31 No6
2010年11月
JOURNAL OF SUN YAT-SEN UNIVERSFTY(MEDICAL SCIENCES
Nov.2010
鼻咽原发性髓外孤立性浆细胞瘤的临床病理特点
向锦',刘大伟2,张玉,吴秋良
(1.华南肿瘤学国家重点实验室//中山大学肿瘤防治中心病理科,广东广州510060
2.中山大学中山医学院病理教研室,广东广州510080)
摘要:【目的】探讨鼻咽髓外孤立性浆细胞瘤(EMP)的临床和病理特征以及其与EB( Epstein-Bar)病毒感染的关
系。【方法】对15例鼻咽EMP进行临床分析、病理检验、随访观察、FBES原位杂交及免疫组织化学标记。【结果】15例鼻
咽FMP,男性患者9例,女性患者6例,男女比1.5:1;中位年龄47岁。影像学资料显示鼻咽黏膜隆起、结节或肿块,未有其
它骨组织病变;病理组织学形态呈现不同分化程度的浆细胞,免疫组织化学结果为单克隆性,并表达B细胞及浆细胞抗原特
性, EBERS原位杂交除1例阳性外,其余14例均阴性。【结论)FMP是一种少见的恶性浆细胞肿掬,它主要发生在头颈部,以
上呼吸道尤其是鼻咽部多发,其确诊须综合影像学、实验室检验及病理资料;免疫组织化学呈单克隆性浆细胞特点;EMP对
放射治疗比较敏感,但约13%的病例可发展为多发性骨瘤,须长期密切随访监测病情的发展;EB病毒在EMP的发病机制
中可能起一定的作用
关键词:鼻咽;浆细胞瘤;骨髓瘤
中图分类号:R735.7
文献标志码:A
文章编号:1672-3554(2010)06-0843-04
Clinicopathologic Features of Solitary Extramedullary Plasmacytoma of Nasopharynx
XIANG Jin, LIU Da-wei, ZHANG Yu WU Qiu-liang
(1. State Key Laboratory of Oncology in South China//Department of Pathology Cancer Center, Sun Yat-sen University, Guangzhou
510060 China; 2. Department of Pathology, Zhongshan Medical School, Sun Yat-sen University, Guangzhou 510080, China)
Abstract Objective] To analyze the clinical and pathological characteristics of olitary extramedullary plasmacytoma(EMP)
of nasopharynx, as well as its relationship with Epstein-barr virus. Methods] We reported 15 cases of solitary extramedullary
plasmacytoma of nasopharynx and studied its clinical, histopathologic and immunhistologic features, follow-up data and EBERS
in-situ hybridization. Results Among 15 cases of Solitary extramedullary plasmacytoma of nasopharynx, 9 cases were male and 6
cases were female, the male-to-female ratio was 1.5: 1. The mean age is 47 years. Imagery data demonstrated mucosa of
nasopharynx swelling or an extensive nodosity filling the nasopharynx, but bone destruction can not be seen. On histological
examination the morphology of EMP consists of sheets of plasma cells of varying degree of differentiation with a monoclonal
phenotype evident by immunohistochemistry, monotypic staining for B-ell and plasma cell antigens. The results of EBERS in-situ
hybridization of 15 cases were almost all negative except one case. Conclusion] EMP is a rare malignant tumor of monoclonal
plasma cells, which shows a preference for the head and neck especially upper respiratory tract i.e. the nasal cavity and
nasopharynx. The diagnosis of EMP should comprehend imagery, laboratory and pathological data. About 13% can progress to
medullary plasmacytoma though its highly radiosensitive and long-term and very close follow-up of these patients can monitor the
progression of the tumor. Epstein-barr virus may have some role in the pathogenesis of EMP of nasopharynx
Key words: nasopharynx; plasmacytoma; medullary plasmacytoma
[J SUN Yat-sen Univ(Med Sci), 2010, 31(6): 843-846]
收稿日期:2010-04-08
基金项自:广东省卫生厅资助项目(303041146001)
作者简介;向锦,硕士,主治医师,研究方向:分子病理,E-mail:xianglin(@mail.ysu.edu.cn;*通信作者:昊秋良,教授,E-mail:Wuqi(
sysu. edu