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[一例因严重贫血检出的胃外髓质浆细胞瘤]

[A Case of Extramedullary Plasmacytoma of the Stomach Detected Due to Severe Anemia].

作者信息

Tamai Koki, Ebisui Chikara, Yamamura Noriyuki, Minoji Takayuki, Takabatake Hiroyuki, Kitahara Tomohiro, Watanabe Noriyuki, Okamura Shu, Fukuchi Nariaki, Yokouchi Hideoki, Kinuta Masakatsu, Ohishi Kazuhito

机构信息

Dept. of Surgery, Suita Municipal Hospital.

出版信息

Gan To Kagaku Ryoho. 2019 Jan;46(1):100-102.

Abstract

A 78-year-oldwoman was referredfor exertional dyspnea. Severe anemia(Hb 4.2 g/dL)was detected, and upper endoscopy revealeda giant ulcer at the posterior wall of the gastric body. Computedtomography showeda mass protruding from the gastric wall, suggestive of a submucosal tumor. Although biopsy did not confirm a diagnosis, we performed distal gastrectomy to control the bleeding. The pathological findings and systemic examination confirmed a diagnosis of extramedullary plasmacytoma of the stomach. Plasmacytoma is a tumor of the bone marrow derived from plasma cells that mature from B cells. The frequency of extramedullary plasmacytoma for all plasmacytoma is about 5% and plasmacytoma derived from the stomach occurs in approximately 2%of these cases. Complete resection with lymph node dissection according to the surgical treatment of gastric cancer is recommended. Large tumors, such as that in the present case, may have a poor prognosis; thus, careful follow-up is required for the early detection of recurrence. We report a case of extramedullary plasmacytoma of the stomach with a literature review.

摘要

一名78岁女性因劳力性呼吸困难前来就诊。检查发现严重贫血(血红蛋白4.2克/分升),上消化道内镜检查显示胃体后壁有一个巨大溃疡。计算机断层扫描显示有一个从胃壁突出的肿块,提示为黏膜下肿瘤。尽管活检未能确诊,但为控制出血我们实施了远端胃切除术。病理检查结果及全身检查确诊为胃外髓质浆细胞瘤。浆细胞瘤是一种起源于从B细胞成熟而来的浆细胞的骨髓肿瘤。所有浆细胞瘤中,髓外浆细胞瘤的发生率约为5%,其中起源于胃的浆细胞瘤约占这些病例的2%。建议按照胃癌的手术治疗方法进行完整切除并清扫淋巴结。像本例这样的大肿瘤预后可能较差;因此,需要密切随访以便早期发现复发情况。我们报告一例胃外髓质浆细胞瘤病例并进行文献复习。

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