Ding Wei, Tan Yulin, Qian Yan, Xue Wenbo, Wang Yibo, Xi Cheng, Gu Kefeng, Xu Yixin, Xu Xuezhong
Department of General Surgery.
Department of Respiration, Changzhou Second People's Hospital Affiliated to Nanjing Medical University.
Medicine (Baltimore). 2019 Jan;98(4):e14235. doi: 10.1097/MD.0000000000014235.
Extramedullary plasmacytomas (EMP) are tumors composed by a monoclonal population of plasma cells that arise in extraosseus tissues, occupying <5% of all plasma cell neoplasms. Gastrointestinal solitary extramedullary plasmacytoma is rare, just comprises about 5% of all EMPs. The most common site is small intestine. The gastric incidence is much rare and especially the plasmablastic plasmacytoma in the stomach.
A 65-year-old man had an epigastric discomfort and mass for about 2 months. Gastroscopy revealed a malignant tumor in the gastric body. Abdomen computed tomography (CT) showed that the gastric cavity was filled, and the irregular soft tissue shadow was seen in the greater curvature, and the enhancement was obvious. To get more tissue, we conducted stomach puncture biopsy. Pathology showed small-round cell malignant tumors. And immunohistochemical examinations revealed that the tumor tend to be a plasma cell tumor.
Gastric plasma cell tumor.
Distal gastrectomy was performed to treat the tumor.
In addition to ascites caused by hypoproteinemia, there were no postoperative complications. Postoperative pathologic report showed plasmablastic plasmacytoma. Histopathologic examination of the specimen revealed plasmablastic plasmacytoma originating in the stomach with transmural extension, but without lymph node metastasis. The patient is regularly followed up at a postoperative clinic and is doing well, and at present there is no plan for adjuvant treatment.
Surgical resection is good option for gastrointestinal EMP.
髓外浆细胞瘤（EMP）是由单克隆浆细胞群体组成的肿瘤，发生于骨外组织，占所有浆细胞肿瘤的不到5%。胃肠道孤立性髓外浆细胞瘤罕见，仅占所有EMP的约5%。最常见的部位是小肠。胃部发病率更低，尤其是胃的浆母细胞性浆细胞瘤。
一名65岁男性上腹部不适伴肿块约2个月。胃镜检查发现胃体部有恶性肿瘤。腹部计算机断层扫描（CT）显示胃腔充盈，大弯侧可见不规则软组织影，强化明显。为获取更多组织，我们进行了胃穿刺活检。病理显示为小圆细胞恶性肿瘤。免疫组化检查显示该肿瘤倾向于浆细胞瘤。
胃浆细胞瘤。
行远端胃切除术治疗该肿瘤。
除低蛋白血症引起的腹水外，无术后并发症。术后病理报告显示为浆母细胞性浆细胞瘤。标本的组织病理学检查显示起源于胃的浆母细胞性浆细胞瘤伴透壁扩展，但无淋巴结转移。患者在术后门诊定期随访，情况良好，目前暂无辅助治疗计划。
手术切除是胃肠道EMP的良好选择。
