Yao Jian, He Xu, Wang Cheng-Yuan, Hao Li, Tan Li-Li, Shen Chun-Jian, Hou Ming-Xiao
Department of Cardiothoracic Surgery, Second Affiliated Hospital of Shenyang Medical College, The Veterans General Hospital of Liaoning Province, Shenyang 110001, Liaoning Province, China.
Department of Pathology, Second Affiliated Hospital of Shenyang Medical College, the Veterans General Hospital of Liaoning Province, Shenyang 110001, Liaoning Province, China.
World J Clin Cases. 2022 Jul 16;10(20):7037-7044. doi: 10.12998/wjcc.v10.i20.7037.
Solitary plasmacytoma in the left rib is rare and can cause chest discomfort such as chest pain and tightness, and its clinical manifestations are not typical, so it is often misdiagnosed. We report a case of left costal plasmacytoma misdiagnosed as angina pectoris. We also review the literature and provide suggestions as to how to avoid misdiagnosis.
A 77-year-old man with a history of intermittent chest tightness for 3 years presented with pain in the left chest for 1 wk and was admitted to hospital. The cardiologists initially diagnosed angina pectoris but the findings of coronary angiography were not consistent with the symptoms. Computed tomography showed that the left eighth rib mass was accompanied by bone destruction. The patient was transferred to our department for further treatment. Preoperative biopsy indicated that the lesion was possibly malignant, and elective surgery was performed to remove the lesion. The size of the tumor was about 4 cm. The tumor was spindle-shaped and protruded into the pleural cavity, without invading the lungs. Postoperative pathology confirmed that the left rib lesion was plasmacytoma. After 14 mo follow-up, the patient died of systemic metastasis.
Left rib solitary plasmacytoma is a rare disease confined to a specific rib and can cause local pain. Attention should be paid to the differential diagnosis of angina pectoris to avoid misdiagnosis.
左肋骨孤立性浆细胞瘤罕见，可引起胸痛、胸闷等胸部不适，临床表现不典型，常易误诊。我们报告1例被误诊为心绞痛的左肋骨浆细胞瘤病例。我们还复习了文献，并就如何避免误诊提供建议。
一名77岁男性，有3年间歇性胸闷病史，因左胸痛1周入院。心脏病专家最初诊断为心绞痛，但冠状动脉造影结果与症状不符。计算机断层扫描显示左第八肋骨肿块伴有骨质破坏。患者转入我科进一步治疗。术前活检表明病变可能为恶性，遂行择期手术切除病变。肿瘤大小约4cm。肿瘤呈纺锤形，突入胸腔，未侵犯肺部。术后病理证实左肋骨病变为浆细胞瘤。随访14个月后，患者死于全身转移。
左肋骨孤立性浆细胞瘤是一种局限于特定肋骨的罕见疾病，可引起局部疼痛。应注意与心绞痛进行鉴别诊断，以避免误诊。
