12例骨孤立性浆细胞瘤临床分析

目的探讨骨孤立性浆细胞瘤(SPB)的诊断和治疗,总结其临床特点。方法回顾性分析12例SPB患者的临床资料,并对该病的临床特点、诊断标准、治疗和预后进行总结。结果所有病例均经病理证实为SPB并符合其诊断标准。12例患者中位随访时间为27个月,其中1例局部复发,3例失访,其余8例未出现病情进展。结论 SPB好发于中老年,是少见的低度恶性肿瘤,主要依靠病理确诊,适当剂量的放疗结合手术是其治疗的最佳手段。     

50例孤立性浆细胞瘤临床分析

目的对孤立性浆细胞瘤(SP)的特点和预后因素进行回顾性分析,以帮助临床诊断、治疗及对预后的判断。方法入组50例SP患者,并对其进行随访,应用Kaplan-Meier法对其临床特点、治疗及预后因素进行回顾性分析。结果髓外浆细胞瘤(EMP)组与骨孤立性浆细胞瘤(SPB)组、放疗组与未放疗组、年龄﹤60岁与年龄≥60岁组的log rank检验结果提示,生存曲线差异均无统计学意义(P均>0.05)。50例SP患者与168例多发性骨髓瘤(MM)患者的生存曲线差异有统计学意义(P<0.05)。结论 SP患者中,EMP与SPB的生存状况无明显差异,SP好发于中老年人,预后较好,部分可转化为MM。     

骨孤立性浆细胞瘤的影像学表现

目的:探讨骨孤立性浆细胞瘤（SBP）的影像学表现,以提高对该病的诊断水平。方法:回顾性分析2012年9月至2020年9月山西省原平市第一人民医院就诊的8例不同部位SBP患者临床及影像学资料,影像学检查包括CT、磁共振成像（MRI）平扫及MRI增强扫描。结果:8例患者病变部位包括胸椎3例、腰椎2例、颅骨2例、肋骨1例,其中影像学检查误诊为胸椎转移瘤、胸椎结核、腰椎淋巴瘤、颅骨脑膜瘤各1例。所有患者均呈溶骨型骨质破坏,可伴有骨质膨胀性改变及软组织肿块。5例椎体病灶均表现为椎体压缩变扁,CT呈等/低密度,T1WI呈等/低信号,T2WI呈低/稍高信号,其中2例呈典型"微脑征"。2例颅骨病灶CT呈稍高密度,T1WI呈等信号,T2WI呈等/混杂高信号。肋骨病灶CT呈等密度,T1WI呈等信号,T2WI呈稍高信号。4例MRI增强扫描病灶呈明显均匀强化。结论:不同部位SBP均表现为溶骨型骨质破坏,病灶及软组织肿块均一强化。"微脑征"为脊柱SBP特异性影像学征象。     

孤立性浆细胞瘤预后相关因素探究*

目的：探究孤立性浆细胞瘤患者的临床特点、治疗方法及预后相关因素。方法：搜集2000年6 月至2012年10月就诊于天津医科大学肿瘤医院的644 例恶性浆细胞肿瘤患者的临床资料,并对其临床特点、治疗方案、预后因素等进行分析,其中孤立性浆细胞瘤（solitary plasmacytoma ,SP）患者有66例占10.25% 。结果：根据SP的发生部位可分为骨孤立性浆细胞瘤（solitary bone plasmacytoma ,SBP ）和髓外浆细胞瘤（extramedullary plasmacytoma ,EMP ）。 SBP 大部分发生在椎体,而髓外浆细胞瘤好发于上呼吸道。此外,两者在肿块大小、血清M 蛋白水平、尿本周氏蛋白水平以及是否更易进展为多发性骨髓瘤（multiple myeloma,MM）等方面的差异均具有统计学意义（P < 0.05）。 多因素分析结果表明,SBP 患者的肿块越大（d≥ 5 cm）,其肿瘤的局部控制率（local control ,LC）、无骨髓瘤进展生存期（multiple myeloma-freesurvival,MMFS）、总生存期（overall survival,OS）及无病进展生存期（progression-free survival ,PFS）越差;对于EMP 患者来说,放以及血清β 2- 微球蛋白< 3.5 mg/L 是预后良好的因素。结论：肿块大小、血清M 蛋白、尿本周氏蛋白、血清β 2- 微球蛋白水平可为临床判断SBP 与EMP 预后及指导治疗提供帮助。     

12例骨孤立性浆细胞瘤的临床特点与预后回顾性分析

背景与目的：骨孤立性浆细胞瘤（SBP）少见，目前国内有关该病的相关临床报道较少。本研究对其特点与预后作一探讨。方法：收集1998--2007年北京大学第三医院确诊的12例SBP患者的临床资料，并对其临床特点、治疗及预后作一回顾性分析。结果：12例SBP患者年龄37～71岁，平均年龄49．6岁，男女比3：1。免疫表型：11例表达CD79a，10例表达VS38C，均不表达CD20。随访12-87个月，平均随访时间（40&#177;22）个月。4例（33％）转为多发性骨髓瘤，其中2例死于感染，中位存活时间73个月，3年和5年生存率分别为90％和75％。结论：SBP好发于中老年男性，预后较好，部分可转化为多发性骨髓瘤。     

1例锁骨近端孤立性骨浆细胞瘤的临床报告

孤立性骨浆细胞瘤是一种以浆细胞单克隆异常增殖为特征的恶性肿瘤。临床上主要以单一骨破坏常见,约占所有浆细胞恶性肿瘤的5%。发生于锁骨近端的孤立性骨浆细胞瘤临床上少见,诊断较困难且容易发生误诊误治。     

孤立性浆细胞瘤21例

孤立性浆细胞瘤(Solitary plasmacytoma,SP)是由浆细胞单克隆增生导致的恶性肿瘤,新版WHO分类中包含髓外浆细胞瘤(extramedullary plasmacy-toma,EMP)和骨的孤立性浆细胞瘤(Solitary plasma-cytoma of bone,SPB)两种变异型(Variety)。     

孤立性浆细胞瘤6例

骨的孤立性骨髓瘤和髓外浆细胞瘤同属于单发浆细胞肿瘤,临床上较少见。我院1990年~2003年间共收治6例,约占同期收治骨髓瘤129例的4.5%,现报告如下。1临床资料6例患者中,5例为骨的孤立性骨髓瘤,1例转化为多发性骨髓瘤,其中男性4例,女性2例,年龄26~63岁。病变发生在前臂尺骨2例,发生在下肢胫骨1例,腰椎1例,胸椎1例。患者均以局部疼痛或者压迫症状就诊,发生在椎体的2例患者出现不同程度的神经压迫症状,重者1例出现截瘫。1例为髓外浆细胞瘤,男性,46岁,病变发生在鼻咽部粘膜。病程1~6年不等。实验室检查:血常规、血沉均正常,血清免疫球蛋白亦在正…     

髓外浆细胞瘤和骨的孤立性浆细胞瘤9例

在浆细胞瘤中，多发性骨髓瘤（mm）常见，而髓外浆细胞瘤（EMP）及骨的孤立性浆细胞瘤（SPB）则罕见。1985—1995年间，作者治疗髓外浆细胞瘤7例，骨的孤立性浆细胞瘤2例。单纯放疗4例，手术加放疗5例。全组3年生存率6／8（7％）。1例SPB在治疗后2年发展为mm，而无1例EMP发生。EMP及SPB治疗后，预后较好。对于预测发展为mm的指标，尚需进一步研究。     

骨孤立性浆细胞瘤18例临床分析

 目的　通过总结分析骨孤立性浆细胞瘤（SBP）的临床特点及治疗方法来提高其诊治水平。方法　回顾分析5家医院1999年至2009年收治的18例SBP的临床资料,对其临床特点及治疗疗效进行总结。结果　18例SBP患者年龄35～78岁,平均年龄54.2岁,男女比2.6∶1。通过随访治疗1～10年,采用化放疗治疗的10例患者有8例生存,2例死于进展为多发性骨髓瘤（MM）,单纯化疗或单纯放疗的8例患者中有1例因化疗相关并发症死亡,2例死于进展为MM。全部患者目前共有11例处于持续缓解状态（CCS）,2例因进展为MM在积极治疗中,平均CCS时间为47.3个月。结论　SBP是低度恶性肿瘤,化疗和放疗是其治疗的主要手段,化放疗相结合预后满意,部分患者可转化为MM。     

Radiotherapy Alone is Associated with Improved Outcomes Over Surgery in the Management of Solitary Plasmacytoma

Background: A moderate dose of radiation is the recommended treatment for solitary plasmacytoma (SP),but there is controversy over the role of surgery. Our study aimed at comparing different treatment modalities inthe management of SP. Materials and Methods: Data from 38 consecutive patients with solitary plasmacytoma,including 16 with bone plasmacytoma and 22 with extramedullary plasmacytoma, were retrospectively reviewed.15 patients received radiotherapy alone; 11 received surgery alone, and 12 received both. The median radiationdose was 50Gy. All operations were performed as radical resections. Local progression-free survival (LPFS),multiple myeloma-free survival (MMFS), progression-free survival (PFS) and overall survival (OS) werecalculated and outcomes of different therapies were compared. Results: The median follow-up time was 55months. 5-year LPFS, MMFS, PFS and OS were 87.0%, 80.9%, 69.8% and 87.4%, respectively. Univariateanalysis revealed, compared with surgery alone, radiotherapy alone was associated with significantly higher5-year LPFS (100% vs 69.3%, p=0.016), MMFS (100% vs 51.4%, p=0.006), PFS (100% vs 33.7%, p=0.0004) andOS (100% vs 70%, p=0.041). Conclusions: Radiotherapy alone can be considered as a more effective treatmentfor SP over surgery. Whether a combination of radiotherapy and surgery improves outcomes requires furtherstudy.     

Solitary plasmacytoma of bone and soft tissue

Between 1962 and 1978, 15 patients presenting with a solitary plasmacytoma were treated with curative intent by radiotherapy alone at the University of Florida. Criteria for admission to this study were: 1) a biopsy-proven, apparently solitary focus of plasmacytoma; 2) bone marrow biopsy showing less than 10% plasma cells; and 3) no evidence of disseminated disease. In 9 patients the primary site was osseous and in 6 patients extramedullary; 5 of the 6 extramedullary lesions were located in the upper respiratory passages. Two of the 6 extramedullary plasmacytomas progressed to multiple myeloma at 2 and 7 months. The remaining 4 patients have been disease free for periods ranging from $\text{2}\text{2}\text{3}$ years to over 16 years. Of the 9 patients with osseous lesions, 3 developed multiple myeloma in 3–23 months and one developed a solitary second bone lesion at 9 years. One patient with a large sacral lesion developed a local recurrence following an initial radiation dose of 3000 rad. The recurrence was re-treated with radiation, and local control was obtained. No other local failures occurred. This study presents a detailed analysis of the time-dose relationship required for local control, based on a study of our own patients and a review of the literature.     

Solitary bone plasmacytoma: outcome and prognostic factors following radiotherapy

Purpose: To clarify the natural history of solitary plasmacytoma of bone (SBP) after radiation treatment.

Methods and Materials: Between 1965–1996, we identified 57 previously untreated patients with a SBP. A serum myeloma protein was present in 33 patients (58%) and Bence Jones proteinuria was present in an additional eight patients (14%). The median radiotherapy dose was 50 Gy (range, 30–70 Gy). Overall survival, cause-specific survival, and freedom from progression to multiple myeloma were calculated actuarially.

Results: Local control was achieved in 55 of 57 patients (96%). For those 29 patients (51%) who subsequently developed multiple myeloma, the median time to progression was 1.8 years. There was a direct correlation between persistence of abnormal protein following radiotherapy and the likelihood of developing multiple myeloma. Among 11 patients with disappearance of myeloma protein, only two developed multiple myeloma after 4 and 12 years, in contrast to progression in 57% of patients with a persistent protein peak and 63% of those with nonsecretory disease (p = 0.02). Among 23 patients with thoracolumbar spine disease, 7 of 8 patients staged with plain radiographs alone developed multiple myeloma in comparison with 1 of 7 patients who also had magnetic resonance imaging (MRI) (p = 0.08). For all patients, the median survival from radiotherapy was 11.0 years. The median cause-specific survival of patients with disappearance of myeloma protein was significantly longer than that of the remaining patients (p = 0.004).

Conclusion: Results supported the importance of precise staging that includes MRI of the spine for optimum patient selection and the application of definitive radiotherapy. Those patients with myeloma protein that disappears following radiotherapy represent a category with a high likelihood of cure.     

Plasmacytoma of the parotid gland

Extramedullary plasmacytoma of the parotid gland is an extremely rare lesion of which there have been only four other reported cases. The importance of these lesions rests in the possibility of their being a harbinger of multiple myeloma or their subsequent transformation to multiple myeloma. Because of its extreme rarity, the proper management remains unclear.     

Solitary plasmacytoma

A Retrospective Review Is Presented Of Nine Patients Presenting With Solitary Plasmacytoma. Between 1963 And 1980, These Patients Were Treated With Radiation At The Department Of Radiation Oncology, University Of Louisville. Criteria For Admission To This Particular Study Include (1) A Solitary Focus Of Plasmacytoma Proven By Biopsy, (2) Normal Bone Marrow Findings (Less Than 10% Plasma Cells), And (3) No Evidence Of Disseminated Disease. In Six Patients The Primary Site Was Osseous, And In Three Extramedullary, Two Of Which Were Located In The Nasopharynx And Nasal Cavity And The Third In The Stomach. All Of The Extramedullary Plasmacytomas Are Disease Free For Periods Ranging From 4 To 10 Years. Of The Six Patients With Osseous Lesions, Two Developed Multiple Myeloma In 2 And 3 Years, Two Are Ned (No Evidence Of Disorder) After 9 Years, One Died Of Intercurrent Disease, And The Remaining Patient Was Ned For 2 Years, After Which He Was Lost To Follow-Up. These Results Suggest The More Favorable Prognosis Of Extramedullary Plasmacytoma And Support The Theory That The Solitary Plasmacytoma Of Bone And Extramedullary Plasmacytoma Are Distinct Disease Entities.     

Sonographic Appearance of Plasmacytoma of the Testis

A case of solitary extramedullary plasmacytoma of the testis is presented demonstrating the appearances on ultrasound. The clinical implications of this diagnosis are discussed.     

Renal Extramedullary Plasmacytoma——One Case Report

T Extramedullary plasmacytoma (EMP) is rare in multiple myeloma, especially kidneys are involved. We report one case, including diagnosis and treatment. The purpose of this paper is to provide an attention on the extramedullary plasmacytoma disease, reducing the misdiagnose with this disease.