Nakamura Yuichi, Kayano Hidekazu, Shimada Tsuneyuki, Ito Yoshihiro, Bessho Masami
Department of Hematology, Saitama Medical University, Saitama.
Intern Med. 2010;49(3):227-30. doi: 10.2169/internalmedicine.49.2240. Epub 2010 Feb 1.
Plasma cell granuloma is a pseudoneoplastic lesion composed of reactive plasma cells of a polyclonal nature and must be distinguished from plasmacytoma. We report a case of plasma cell granuloma in the sigmoid colon associated with diverticulosis. In this case, the lesion consisted of multiple submucosal tumors with prominent infiltration of polyclonal plasma cells. Although the patient exhibited IgM-type monoclonal gammopathy, the expression of a monoclonal immunoglobulin was not detected in the sigmoid colonic lesion, but in the bone marrow cells. Plasma cell granuloma in the lower alimentary tract has been rarely reported. Recurrent inflammatory process with diverticular disease was considered as a pathogenesis of the pseudoneoplasm and a possible cause of monoclonal proliferation of IgM-producing lymphoid cells in this case.
浆细胞性肉芽肿是一种由多克隆性反应性浆细胞组成的假性肿瘤性病变，必须与浆细胞瘤相鉴别。我们报告一例乙状结肠浆细胞性肉芽肿伴憩室病。在该病例中，病变由多个黏膜下肿瘤组成，伴有多克隆浆细胞显著浸润。尽管患者表现出IgM型单克隆丙种球蛋白病，但在乙状结肠病变中未检测到单克隆免疫球蛋白的表达，而是在骨髓细胞中检测到。下消化道浆细胞性肉芽肿鲜有报道。憩室病反复炎症过程被认为是该假性肿瘤的发病机制，也是该病例中产生IgM的淋巴细胞单克隆增殖的可能原因。
