Hanawa T, Sawai S, Matsui T, Chiba W, Watanabe S, Matsubara Y, Hatakenaka R, Funatsu T, Ikeda S
Respiratory Division, Kyoto-Katsura Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Jun;32(6):616-20.
A 58-year-old man with a solitary plasmacytoma of the chest wall is reported. He was admitted because of a painless tumor on the right lateral chest wall. The chest CT scan showed a chest wall tumor surrounding the 7th and 8th ribs without rib destruction. A transcutaneous needle biopsy of the tumor with a Sure-Cut-Needle revealed a plasmacytoma. The bone marrow biopsy findings were normal. Under a diagnosis of solitary plasmacytoma, the chest wall tumor was resected. The tumor was an extramedullary plasmacytoma. Southern blot analysis of the immunoglobulin light chain gene of the tumor cells detected a rearrangement of genes in the lambda chain, while no rearrangements of immunoglobulin genes were detected in the bone marrow specimen. Seven months later another solitary plasmacytoma was found at the left radius, and was resected. Southern blot analysis of the immunoglobulin light chain gene was useful in the differential diagnosis from systemic myeloma and in determining the monoclonality of the tumor.
报告了一名58岁患有胸壁孤立性浆细胞瘤的男性。他因右侧胸壁无痛性肿瘤入院。胸部CT扫描显示胸壁肿瘤包绕第7和第8肋骨，无肋骨破坏。用Sure-Cut-针经皮穿刺肿瘤活检显示为浆细胞瘤。骨髓活检结果正常。在诊断为孤立性浆细胞瘤后，切除了胸壁肿瘤。该肿瘤为髓外浆细胞瘤。对肿瘤细胞免疫球蛋白轻链基因的Southern印迹分析检测到λ链基因重排，而在骨髓标本中未检测到免疫球蛋白基因重排。7个月后，在左桡骨发现另一个孤立性浆细胞瘤并进行了切除。免疫球蛋白轻链基因的Southern印迹分析有助于与系统性骨髓瘤进行鉴别诊断并确定肿瘤的单克隆性。
