Humphrey D M, Aufdemorte T B, Gates G A
Laryngoscope. 1983 Nov;93(11 Pt 1):1476-80.
A 60-year-old man developed a left VIth-nerve paralysis and underwent biopsy of an extramedullary plasmacytoma in the sphenoid sinus. Immunohistochemistry demonstrated cytoplasmic IgD and lambda determinants. Subsequent specimens from left clavical and thoracic epidural lesions also showed a plasma cell neoplasm with IgD and lambda determinants. No abnormal plasma cells were found in bone marrow specimens. Lambda Bence-Jones protein and monoclonal IgD-lambda protein in the serum were detected several months after onset. The patient died with disseminated plasmacytoma 1 year after diagnosis. The mode of presentation, pattern of metastasis, and secretory features were typical of extramedullary plasmacytoma arising in the upper airway. Immunohistochemistry was more productive than serum electrophoresis and immunoelectrophoresis for following the course of this neoplasm.
一名60岁男性出现左侧第六脑神经麻痹，并对蝶窦内的髓外浆细胞瘤进行了活检。免疫组织化学显示胞质内有IgD和λ轻链决定簇。随后取自左锁骨和胸段硬膜外病变的标本也显示为具有IgD和λ轻链决定簇的浆细胞瘤。骨髓标本中未发现异常浆细胞。发病数月后在血清中检测到λ本-周蛋白和单克隆IgD-λ蛋白。该患者在诊断后1年死于播散性浆细胞瘤。其临床表现方式、转移模式及分泌特征均为上呼吸道髓外浆细胞瘤的典型表现。对于追踪该肿瘤的病程，免疫组织化学比血清电泳和免疫电泳更有效。
