原发性气管髓外浆细胞瘤临床分析
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上海长海医院呼吸内科,长海医院呼吸内科

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Clinical Analysis of Primary Tracheal Extramedullary Plasmacytoma
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Department of Respiratory Medicine,Changhai Hospital,Second Military University

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    目的 探讨原发性气管髓外浆细胞瘤的临床特征、诊疗方法及预后。 方法 对本院1例及中外文文献报道的9例原发性气管髓外浆细胞瘤病例进行回顾性总结,分析其临床资料。结果 本院病例因“体检发现气管占位”入院,经电子支气管镜检查并行高频圈套治疗,术后病理确诊髓外浆细胞瘤,排除全身其他部位病变后胸外科行手术根治治疗。文献报道的9例患者中症状以呼吸困难(7/9)为主,其次为咳嗽(4/9),咯血(1/9)。8例有胸部CT检查资料,胸部CT检查均可见气管占位,1例系在行甲状腺B超检查时意外发现气管上段前部占位。单纯手术治疗5例;单纯支气管镜下治疗2例,其中1例行硬质支气管镜下切除,1例行腔镜下摘除、基底部灼烧;手术、局部放疗1例;支气管镜下高频圈套、激光、局部放疗1例。7例有较完整的随访资料,随访时间为3月至24月,均未见局部复发及远处转移。 结论 原发性气管髓外浆细胞瘤是一种临床罕见的疾病,确诊需依靠病理及免疫组化结果,目前治疗多以腔镜下摘除或手术切除,术后予以局部放疗为主。

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    [abstract] Objective To explore the clinical features、diagnosis and treatment methods and prognosis of the primary tracheal Extramedullary Plasmacytoma. Methods One case of our hospital and nine cases reported in chinese-foreign language were retrospectively summarized and analyzed. Results The case in our hospital was admitted to hospital for tracheal neoplasm , patient was treated by high frequency electrocautery, and pathological findings was Extramedullary Plasmacytoma. The main symptoms of other 9 cases were dyspnea (7/9), cough (4/9) , hemoptysis (1/9). 8 cases were founded tracheal neoplasm by the means of chest CT examination, and 1 case was discovered by means of B ultrasound. 5 cases were Simplely treated by surgery; 2 cases were treated under the bronchoscope : 1 of which under rigid bronchoscope; 1 of which treated by high frequency electrocautery and high frequency electric coagulation under the bronchoscope;1 cases was treated by surgery plus local radiotherapy;1 case was treated by high frequency electrocautery 、laser and local radiotherapy. 7 cases had complete follow-up data for 3 months to 24 months, and no local recurrence and distant metastasis were founded. Conclusion Primary tracheal extramedullary plasmacytoma is a rare clinical disease, diagnosis depends on pathological and immunohistochemical results, and at present the main treatments are remove under the bronchoscope、surgical resection, or postoperative local radiotherapy.

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  • 收稿日期:2013-07-19
  • 最后修改日期:2013-11-09
  • 录用日期:2013-12-26
  • 在线发布日期: 2014-09-22
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