Park Il Gwon, Lee Yun Jung, Park Do Hyun, Han Song Yi, Lee Gin Hyug, Myung Seung-Jae, Yang Suk-Kyun, Hong Weon-Seon, Kim Jin-Ho, Min Young Il
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu, Seoul, Korea.
Korean J Gastroenterol. 2003 Jul;42(1):67-71.
Extramedullary plasmacytoma is a rare disease in which a neoplastic proliferation of plasma cells originates from the outside of the bone marrow. The jejunum is the most common site of extramedullary plasmacytoma of the gastrointestinal tract and its common complications are intestinal obstruction due to mass, gastrointestinal bleeding, and intussusception. A 68-year-old woman presented with intermittent postprandial abdominal pain, vomiting, and weight loss. Abdomen and pelvis CT revealed diffuse wall thickening of the proximal jejunum. Small bowel series and enteroclysis revealed a short segment stricture of the proximal jejunum. A 2 cm long jejunal stricture was detected on peritoneoscopic surgery. A pathology showed a solid mass beneath the submucosa grossly and malignant plasma cell infiltration microscopically. A immunochemical staining showed monoclonal kappa chain expression. A bone marrow examination showed only mild reactive plasmacytosis. Serum protein electrophoresis, skull and spine X-ray showed no specific abnormality, and urinary Bence Jones protein was negative.
髓外浆细胞瘤是一种罕见疾病,其中浆细胞的肿瘤性增殖起源于骨髓之外。空肠是胃肠道髓外浆细胞瘤最常见的部位,其常见并发症为肿块导致的肠梗阻、胃肠道出血和肠套叠。一名68岁女性出现餐后间歇性腹痛、呕吐和体重减轻。腹部和盆腔CT显示空肠近端肠壁弥漫性增厚。小肠造影和小肠灌肠显示空肠近端有短段狭窄。在腹腔镜手术中发现一段2厘米长的空肠狭窄。病理检查显示黏膜下有一个实性肿块,显微镜下可见恶性浆细胞浸润。免疫化学染色显示单克隆κ链表达。骨髓检查仅显示轻度反应性浆细胞增多。血清蛋白电泳、颅骨和脊柱X线检查未发现特异性异常,尿本-周蛋白阴性。