Homma K, Ihzumi T, Nemoto K, Ohnishi Y
Second Department of Pathology, Niigata University School of Medicine, Japan.
Int J Hematol. 1992 Oct;56(2):179-84.
We report a case of primary extramedullary plasmacytoma (PEMP), IgA kappa type, with a long clinical history, in a 64-year-old Japanese woman. In this case, PEMP occurred primarily in the jejunum and then recurred in several organs, specifically the spleen and stomach, and in the subcutaneous tissue, over a period of about 16 years. However, examination of bone marrow aspirates on several occasions continued to show no plasmacytoma involvement. The patient is still living. Immunohistochemical examinations revealed monoclonal IgA kappa immunoglobulin in the cytoplasm of infiltrating plasma cells in all surgical specimens examined. Immunoelectrophoresis revealed serum M-component only when the patient had a splenic tumor. Soon after splenectomy, the serum M-component disappeared. PEMP of the small intestine is rare.
我们报告了一例64岁日本女性原发性髓外浆细胞瘤（PEMP），IgA κ型，临床病史较长。在该病例中，PEMP主要发生于空肠，随后在约16年的时间里在多个器官复发，具体为脾脏、胃以及皮下组织。然而，多次骨髓穿刺检查均未发现浆细胞瘤累及。患者仍在世。免疫组织化学检查显示，在所有检查的手术标本中，浸润浆细胞的细胞质内存在单克隆IgA κ免疫球蛋白。免疫电泳显示，仅在患者出现脾脏肿瘤时血清中存在M成分。脾切除术后不久，血清M成分消失。小肠原发性髓外浆细胞瘤较为罕见。
