Department of Neurology, Wayne State University, Detroit Medical Center, Detroit, MI, USA.
J Neurooncol. 2012 Jan;106(2):327-37. doi: 10.1007/s11060-011-0667-5. Epub 2011 Jul 24.
Plasma cell granuloma (PCG) is an uncommon non-neoplastic mass lesion of unknown etiology. It is characterized by a polyclonal proliferation of chronic inflammatory cells, mostly mature plasma and other mononuclear cells. PCGs arising in the central nervous system are particularly rare. We report two additional cases of intracranial PCG exclusively involving the brain parenchyma. A 47 year-old woman, presenting with partial motor seizures and fluent aphasia, underwent complete excision of a well-demarcated, enhancing left parietal mass. The second patient was a 56 year-old man presenting with headaches and right-sided weakness who underwent stereotactic biopsy of an ill-defined, heterogeneously enhancing lesion in the left basal ganglia. Immunohistochemical analysis of surgical specimens showed polyclonal plasma cells and mature lymphocytes but no etiological agent. A histopathologic diagnosis of intracranial PCG was made in both cases. PCG should be part of the differential diagnosis of enhancing mass lesions of the brain. The etiology and natural history of these tumor-like lesions is not fully understood. Complete surgical excision appears to be curative. Lesions where total resection is not possible may benefit from adjuvant treatment including corticosteroids and possibly radiation therapy.
浆细胞肉芽肿（PCG）是一种罕见的、病因不明的非肿瘤性肿块病变。其特征是慢性炎症细胞的多克隆增殖，主要为成熟浆细胞和其他单核细胞。中枢神经系统中的 PCG 尤其罕见。我们报告了另外两例仅累及脑实质的颅内 PCG。一例是 47 岁女性，表现为部分运动性癫痫发作和流利性失语，行完全切除界限清楚、增强的左顶叶肿块。第二例是 56 岁男性，表现为头痛和右侧无力，行左侧基底节区界限不清、不均匀增强病变的立体定向活检。手术标本的免疫组织化学分析显示多克隆浆细胞和成熟淋巴细胞，但无病因。两种情况下均作出颅内 PCG 的组织病理学诊断。PCG 应作为脑内增强肿块病变的鉴别诊断之一。这些肿瘤样病变的病因和自然病史尚未完全清楚。完全手术切除似乎是可治愈的。对于无法完全切除的病变，辅助治疗可能有益，包括皮质类固醇和可能的放射治疗。
