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肾浆细胞瘤:一例罕见病例报告及文献综述

Renal plasmacytoma: Report of a rare case and review of the literature.

作者信息

Zhang Shi-Qiang, Dong Pei, Zhang Zhi-Ling, Wu Song, Guo Sheng-Jie, Yao Kai, Li Yong-Hong, Liu Zhuo-Wei, Han Hui, Qin Zi-Ke, Cai Zhi-Ming, Li Xian-Xin, Zhou Fang-Jian

机构信息

State Key Laboratory of Oncology in Southern China, Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060;

出版信息

Oncol Lett. 2013 Jun;5(6):1839-1843. doi: 10.3892/ol.2013.1282. Epub 2013 Apr 3.

Abstract

Renal plasmacytoma is extremely rare, presenting diagnostic challenges due to its unusual location and non-specific or absent symptoms. To the best of our knowledge, only 24 cases of renal plasmacytoma have been reported in the literature. The present study reports a case of primary renal plasmacytoma in a 46-year-old female patient. Computed tomography (CT) revealed that the mass was located in the lower pole of the left kidney and metastasis was detected in an enlarged para-aortic lymph node. Following careful preparation, a partial nephrectomy was performed and the retroperitoneal lymph node was resected. A pathological examination revealed a renal parenchyma with lymph node involvement; this was confirmed by immunohistochemistry and nested polymerase chain reaction (PCR). Consequently, a diagnosis of a renal extramedullary plasmacytoma (EMP) was proposed. Following this unexpected diagnosis, various examinations were performed, but there was no evidence of systemic plasma cell disease. The patient refused further therapy, including external beam radiotherapy and chemotherapy. Abdominal CT was performed three months post-surgery and did not reveal any relapse. The patient remains disease-free at nine months post-surgery. The current study also presents a review of the literature. Although the general prognosis and outcome of EMP is good, a follow-up examination is recommended due to the possibility of relapse or progression to plasma cell neoplasm (PCN).

摘要

肾浆细胞瘤极为罕见,因其位置特殊且症状不具特异性或无症状而带来诊断挑战。据我们所知,文献中仅报道了24例肾浆细胞瘤。本研究报告了一例46岁女性原发性肾浆细胞瘤患者。计算机断层扫描(CT)显示肿块位于左肾下极,在主动脉旁肿大淋巴结中检测到转移。经过精心准备,实施了部分肾切除术并切除了腹膜后淋巴结。病理检查显示肾实质伴有淋巴结受累;免疫组织化学和巢式聚合酶链反应(PCR)证实了这一点。因此,提出了肾髓外浆细胞瘤(EMP)的诊断。在这一意外诊断之后,进行了各种检查,但没有全身浆细胞疾病的证据。患者拒绝进一步治疗,包括体外放疗和化疗。术后三个月进行腹部CT检查,未发现任何复发迹象。患者术后九个月仍无疾病复发。本研究还对文献进行了综述。尽管EMP的总体预后和结局良好,但由于有复发或进展为浆细胞肿瘤(PCN)的可能性,建议进行随访检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf96/3700893/6db7f113eef7/OL-05-06-1839-g00.jpg

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