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中华腔镜泌尿外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (01) : 60 -64. doi: 10.3877/cma.j.issn.1674-3253.2021.01.015

所属专题: 经典病例 文献

病例研究

孤立性膀胱浆细胞瘤的病例分析及文献复习
梁嘉华1, 曹家栋2, 王树声3,()   
  1. 1. 510006 广州中医药大学第二临床学院
    3. 518021 广州,广东省中医院泌尿外科
  • 收稿日期:2020-03-04 出版日期:2021-02-01
  • 通信作者: 王树声

Solitary bladder plasmocytoma: A case report and literature review

Jiahua Liang1, Jiadong Cao2, Shusheng Wang3,()   

  1. 1. Guangzhou University of Chinese Medicine, Guangzhou 510006, China
    2. Department of Urology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510105, China
  • Received:2020-03-04 Published:2021-02-01
  • Corresponding author: Shusheng Wang
引用本文:

梁嘉华, 曹家栋, 王树声. 孤立性膀胱浆细胞瘤的病例分析及文献复习[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2021, 15(01): 60-64.

Jiahua Liang, Jiadong Cao, Shusheng Wang. Solitary bladder plasmocytoma: A case report and literature review[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2021, 15(01): 60-64.

目的

探讨孤立性膀胱浆细胞瘤的临床表现、诊断与治疗。

方法

回顾分析我院于20l9年5月10日收治的1例膀胱浆细胞瘤患者的临床病理特征资料、诊疗过程、随访情况,总结现有文献讨论并总结本病诊治心得。

结果

51岁女性,因尿急尿痛入院。术前CT增强考虑肿瘤性病变,未除外膀胱癌,行膀胱镜检查+经尿道膀胱肿瘤电切术。术后病理提示为黏膜固有层内见大小一致的肿瘤细胞弥漫浸润,核偏位,呈浆细胞样,核分裂象罕见,高度疑为浆细胞瘤。免疫组化染色:Ki67(2%+),CD38(+),CD138(+),Kappa(+),Lambda(-)。术后予行进一步放疗(50Gy/25F),7个月后复查未见肿瘤复发及转移。

结论

膀胱浆细胞瘤临床上极其罕见,无特征性临床表现,治疗推荐选用根治性放疗联合手术切除;另外,血液科、放疗科和外科医师间的紧密协作对于制定合适的治疗方案至关重要。

Objective

To discuss the clinical manifestations, diagnosis and treatment of solitary extramedullary plasmacytoma of the bladder.

Methods

The clinical pathological features and follow-up of patient were analyzed retrospectively and the related literature were reviewed.

Results

A-51-year old female patient with the complaint of urgency of micturition and urodynia was admitted. CT with enhancement considered her as neoplastic lesions of bladder and she underwent transurethral resection of bladder tumor. Pathological results showed consistent tumor cells were seen in the lamina propria of the mucosa with diffuse infiltration, nuclear deviation, plasma cell-like appearance, and rare mitosis. Immunohistochemical staining showed Ki67 (2%+), CD38 (+), CD138 (+), Kappa (+), Lambda (-). She was diagnosed as bladder extramedullary plasmacytoma .Further radiotherapy was given after the operation, and no recurrence or metastasis was found during regular follow-up.

Conclusions

Solitary extramedullary plasmacytoma of bladder is extremely rare without any characteristic clinical manifestations. Radical radiotherapy combined with surgical resection is recommended, besides, close collaboration among hematologists, radiologists, and surgeons should be essential for appropriate treatment.

图1 CT提示膀胱占位性病变
图2 膀胱肿物切除术后病理免疫组化结果(HE×400)
表1 孤立性膀胱浆细胞瘤相关文献病例报道列表
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