Lee Li-Ang, Fang Tuan-Jen, Li Hsueh-Yu
Department of Otolaryngology, Chang Gung Memorial Hospital, and Chang Gung University, Taoyuan, Taiwan.
Am J Otolaryngol. 2002 Sep-Oct;23(5):316-20. doi: 10.1053/ajot.2002.124196.
Solitary plasmacytosis of the larynx is a clinically unusual event. It may cause hoarseness or airway obstruction and usually needs surgical excision. Plasmacytosis is distinguished from extramedullary plasmacytoma (EMP) in that the latter primarily involves the head and neck and needs more intensive therapy such as radiotherapy. Many reports have described the histopathology and immunohistochemistry of EMP of the larynx; however, no literature in English has described solitary plasmacytosis of the larynx. We report a 44-year-old female patient with non-Hodgkin's lymphoma and systemic lupus erythromatosus with Sjögren's syndrome. She complained of 1-year period of hoarseness that became exacerbated in the most recent 3 weeks. A wide-base and smooth-surface mass at the left supraglottic area was noted by direct laryngoscope. Computed tomography scan revealed a well-defined radiopaque mass. The histopathology of a specimen excised by carbon dioxide laser-assisted laryngomicrosurgery was interpreted initially as plasmacytoma. Immunohistochemical staining for kappa and lambda light chains demonstrated polyclonal plasma cells, and the definitive diagnosis was plasmacytosis. After 6 months follow-up, the subjective quality of her voice improved. Laryngoscopic examination revealed no evidence of recurrence.
喉孤立性浆细胞增多症是一种临床罕见的病症。它可能导致声音嘶哑或气道阻塞，通常需要手术切除。浆细胞增多症与髓外浆细胞瘤（EMP）的区别在于，后者主要累及头颈部，需要更强化的治疗，如放疗。许多报告描述了喉EMP的组织病理学和免疫组织化学；然而，尚无英文文献描述喉孤立性浆细胞增多症。我们报告一例44岁女性患者，患有非霍奇金淋巴瘤、系统性红斑狼疮及干燥综合征。她主诉声音嘶哑1年，最近3周加重。直接喉镜检查发现左侧声门上区有一个基底较宽、表面光滑的肿物。计算机断层扫描显示有一个边界清晰的不透光肿物。经二氧化碳激光辅助喉显微手术切除标本的组织病理学最初诊断为浆细胞瘤。κ和λ轻链的免疫组织化学染色显示为多克隆浆细胞，最终诊断为浆细胞增多症。随访6个月后，她的主观嗓音质量有所改善。喉镜检查未发现复发迹象。
