目的探讨骨孤立性浆细胞瘤(solitary plasmacytoma of bone,SPB)的临床病理特征、免疫表型、鉴别诊断及治疗。方法对1例锁骨孤立性浆细胞瘤进行光镜观察,免疫组化染色并结合文献进行复习。结果镜下肿瘤细胞核偏位,可见双核及多核瘤巨细...目的探讨骨孤立性浆细胞瘤(solitary plasmacytoma of bone,SPB)的临床病理特征、免疫表型、鉴别诊断及治疗。方法对1例锁骨孤立性浆细胞瘤进行光镜观察,免疫组化染色并结合文献进行复习。结果镜下肿瘤细胞核偏位,可见双核及多核瘤巨细胞,异型明显;该肿瘤术前已浸润周围软组织,形成肿块,术后迅速播散。免疫表型:瘤细胞表达VS38C及κ;Ki-67高表达。结论骨孤立性浆细胞瘤属少见病例,本例临床表现及病理形态较为特殊,需与弥漫性大B细胞性淋巴瘤、间变性大细胞淋巴瘤、低分化癌相鉴别。展开更多
Purpose: Solitary bone plasmacytoma [SBP] is a localised variant of plasma cell tumor which commonly affects the axial skeleton but rarely found in the maxillofacial region. We hereby report an unusual case of solitar...Purpose: Solitary bone plasmacytoma [SBP] is a localised variant of plasma cell tumor which commonly affects the axial skeleton but rarely found in the maxillofacial region. We hereby report an unusual case of solitary plasmacytoma of the right zygomatic bone in a 70-year-old Nigerian. Case Report: The patient presented with a painless right zygomatic swelling of 2 years duration. Examination showed that the swelling was of mixed consistency [mostly bony but firm in some areas] and it measured about 8 × 8 cm. Radiographic examination revealed an osteolytic lesion over the right zygoma with involvement of the apex and lateral wall of the antrum. An initial working diagnosis of ossifying fibroma was made and the patient was scheduled for surgery. Histological staining with H & E and immunohistochemistry of the surgical specimen however confirmed a diagnosis of SBP. Serum monoclonal protein and Bence Jones proteinuria was negative throughout the follow up period. Conclusion: SBP of the maxillofacial region is amenable to surgery combined with postoperative radiotherapy. However, prognosis can be worsened with tumor recurrence or dissemination into MM. Thus patients with SBP must be closely followed up after treatment so that immediate therapeutic steps can be taken if recurrence or systemic dissemination is encountered.展开更多
目的探讨脊椎骨孤立性浆细胞瘤(solitary plasmacytoma of spine, SPS)的MRI特征及相关病理机制。材料与方法回顾性分析17例经手术和病理证实SPS患者的MRI特征及相关病理机制。结果肿瘤位于颈椎1例,胸椎8例,腰椎8例。17例SPS均表现椎体...目的探讨脊椎骨孤立性浆细胞瘤(solitary plasmacytoma of spine, SPS)的MRI特征及相关病理机制。材料与方法回顾性分析17例经手术和病理证实SPS患者的MRI特征及相关病理机制。结果肿瘤位于颈椎1例,胸椎8例,腰椎8例。17例SPS均表现椎体不同程度溶骨性骨质破坏,轻度膨胀性改变,14例累及附件,13例椎体压缩楔变;13例椎体边缘形成不对称软组织肿块,12例软组织肿块突入椎管内,7例包绕椎管形成“围管征”;T1WI序列呈等、低信号,T2WI序列多呈等或略高信号;增强扫描均明显均匀强化,14例表现为“微脑样”征象。病理组织学特征:肿瘤细胞由弥漫性密集排列的小圆细胞组成,几乎没有细胞间基质。免疫表型:17例均表达CD138及CD38,12例表达Kap,7例表达Lambda,11例表达CD79a,仅2例表达CD20。结论 SPS的MRI表现具有一定的特征性,了解其MRI特征及相关病理机制有助于与其他单发脊椎肿瘤鉴别,可提高术前诊断准确性。展开更多
文摘目的探讨骨孤立性浆细胞瘤(solitary plasmacytoma of bone,SPB)的临床病理特征、免疫表型、鉴别诊断及治疗。方法对1例锁骨孤立性浆细胞瘤进行光镜观察,免疫组化染色并结合文献进行复习。结果镜下肿瘤细胞核偏位,可见双核及多核瘤巨细胞,异型明显;该肿瘤术前已浸润周围软组织,形成肿块,术后迅速播散。免疫表型:瘤细胞表达VS38C及κ;Ki-67高表达。结论骨孤立性浆细胞瘤属少见病例,本例临床表现及病理形态较为特殊,需与弥漫性大B细胞性淋巴瘤、间变性大细胞淋巴瘤、低分化癌相鉴别。
文摘Purpose: Solitary bone plasmacytoma [SBP] is a localised variant of plasma cell tumor which commonly affects the axial skeleton but rarely found in the maxillofacial region. We hereby report an unusual case of solitary plasmacytoma of the right zygomatic bone in a 70-year-old Nigerian. Case Report: The patient presented with a painless right zygomatic swelling of 2 years duration. Examination showed that the swelling was of mixed consistency [mostly bony but firm in some areas] and it measured about 8 × 8 cm. Radiographic examination revealed an osteolytic lesion over the right zygoma with involvement of the apex and lateral wall of the antrum. An initial working diagnosis of ossifying fibroma was made and the patient was scheduled for surgery. Histological staining with H & E and immunohistochemistry of the surgical specimen however confirmed a diagnosis of SBP. Serum monoclonal protein and Bence Jones proteinuria was negative throughout the follow up period. Conclusion: SBP of the maxillofacial region is amenable to surgery combined with postoperative radiotherapy. However, prognosis can be worsened with tumor recurrence or dissemination into MM. Thus patients with SBP must be closely followed up after treatment so that immediate therapeutic steps can be taken if recurrence or systemic dissemination is encountered.
