From the Department of Pathology, Warren Alpert Medical School of Brown University, Lifespan Academic Medical Center, Providence, Rhode Island.
Arch Pathol Lab Med. 2018 Aug;142(8):998-1005. doi: 10.5858/arpa.2017-0068-RS.
Plasma cell granuloma (PCG) is characterized by proliferation of polyclonal plasma cells with associated fibrosis and is often considered part of the heterogeneous group of inflammatory myofibroblastic tumors (IMTs). The thyroid is rarely affected by PCG. A patient having PCG associated with Hashimoto thyroiditis (HT) prompted our literature search that revealed 18 cases of PCG, 55% (n = 10) of which occurred together with HT. The etiopathogenesis of PCG is unknown and there is no specific treatment except surgical excision for compressive symptoms. This entity has an excellent prognosis with no evidence of recurrence or metastasis. Lesions of the thyroid with infiltrating plasma cells include HT, fibrous variant of HT, plasmacytoma, plasma cell myeloma, Riedel thyroiditis, IgG4 (immunoglobulin G4)-related disease, IMT, and PCG. Inflammatory myofibroblastic tumor has ALK gene rearrangements and is considered a neoplasm as opposed to PCG, which is a reactive polyclonal plasma cell proliferation. We believe IMT and PCG are distinct entities and consensus definitions are required for avoiding confusion in the literature.
浆细胞性肉芽肿 (PCG) 的特征是多克隆浆细胞增殖伴纤维化，通常被认为是炎症性肌纤维母细胞瘤 (IMT) 异质性组的一部分。甲状腺很少受 PCG 影响。一例与桥本甲状腺炎 (HT) 相关的 PCG 促使我们进行文献检索，结果显示有 18 例 PCG，其中 55%（n=10）与 HT 同时发生。PCG 的病因发病机制尚不清楚，除了因压迫症状而行手术切除外，尚无特异性治疗方法。该疾病具有极好的预后，无复发或转移的证据。伴有浆细胞浸润的甲状腺病变包括 HT、HT 的纤维变异型、浆细胞瘤、浆细胞骨髓瘤、Riedel 甲状腺炎、IgG4（免疫球蛋白 G4）相关疾病、IMT 和 PCG。炎症性肌纤维母细胞瘤存在 ALK 基因重排，被认为是一种肿瘤，而不是 PCG，PCG 是一种反应性多克隆浆细胞增殖。我们认为 IMT 和 PCG 是不同的实体，需要有共识定义以避免在文献中混淆。
