Jaubert D, Hauteville D, Verdier M, Houdelette P, Gisserot D, Dupin-Nizard B, Sahel J
Gastroenterol Clin Biol. 1985 Jun-Jul;9(6-7):532-4.
A case of plasmacytoma of the head of the pancreas in a 75-year-old woman, revealed by obstructive jaundice, is reported. The tumor, which compressed the main bile duct, appeared to be round on sonographic and endoscopic retrograde cholangiographic investigations. Sonographically guided needle biopsy was performed but led to the erroneous diagnosis of pancreatic adenocarcinoma. Choledochojejunostomy and gastrojejunostomy were then performed but the patient died 10 days after the operation. Pathological examination of the specimens obtained at autopsy showed that the pancreatic tumor (as well as an other osseous lesion) were plasmacytomas with cells containing G immunoglobulins of the lambda type. Despite the failure of needle biopsy to lead to correct diagnosis in this case, the potential value of this method remains unequivocal as reported previously. Indeed, when positive results are obtained by this method in visceral localizations of plasmacytoma, hazardous surgery may be avoided and radiation and/or chemotherapy may be chosen preferentially.
本文报道了一例75岁女性胰腺头部浆细胞瘤，该病例由梗阻性黄疸发现。肿瘤压迫胆总管，在超声和内镜逆行胆管造影检查中呈圆形。进行了超声引导下针吸活检，但误诊为胰腺腺癌。随后进行了胆总管空肠吻合术和胃空肠吻合术，但患者术后10天死亡。尸检标本的病理检查显示，胰腺肿瘤（以及另一处骨病变）为浆细胞瘤，细胞含有λ型G免疫球蛋白。尽管在该病例中针吸活检未能得出正确诊断，但如先前报道，该方法的潜在价值仍很明确。事实上，当通过该方法在内脏部位的浆细胞瘤中获得阳性结果时，可避免危险的手术，优先选择放疗和/或化疗。
