Marisavljevic D, Markovic O, Cemerkic-Martinovic V, Ponomarev D
Department of Hematology, Medical Training Center Bezanijska Kosa, 11080 Belgrade, Serbia and Montenegro.
Med Oncol. 2005;22(2):207-10. doi: 10.1385/MO:22:2:207.
Solitary lung plasmacytoma is a rare form of plasma cell tumors. The case of a 56-yr-old man is presented, who had a massive tumor of the right pulmonary apex. Percutaneous transthoracic lung biopsy demonstrated a tumor-cell population consisting of mature plasma cells, proplasmacytes, and rare plasmablasts. Immunohistochemically, the cells were CD79a+, kappa+, cyclin D1-, p53-, MDR-. Proliferative index was low (number of Ki-67+ tumor cells was 8%). Serum and urine immunoelectrophoresis did not show the presence of paraprotein. Screening for multiple myeloma with skeletal X-ray survey and bone marrow biopsy were negative. Radiotherapy and chemotherapy with alkylating agents were ineffective. However, the course of the disease is indolent and the patient is well, alive, and with no signs of multiple myeloma >5 yr after the diagnosis was established. Some pathogenetic aspects of tumor resistance to conventional myeloma treatment in this case are discussed.
孤立性肺浆细胞瘤是浆细胞肿瘤的一种罕见形式。本文报告了一例56岁男性病例，该患者右肺尖有一个巨大肿瘤。经皮经胸肺活检显示肿瘤细胞群体由成熟浆细胞、原浆细胞和罕见的浆母细胞组成。免疫组化显示，细胞CD79a阳性、κ阳性、细胞周期蛋白D1阴性、p53阴性、多药耐药蛋白阴性。增殖指数较低（Ki-67阳性肿瘤细胞数量为8%）。血清和尿免疫电泳未显示副蛋白的存在。骨骼X线检查和骨髓活检筛查多发性骨髓瘤均为阴性。使用烷化剂进行放疗和化疗无效。然而，疾病进程较为惰性，患者在确诊后5年多情况良好，存活且无多发性骨髓瘤迹象。本文讨论了该病例中肿瘤对传统骨髓瘤治疗耐药的一些发病机制方面的问题。
