Hussong J W, Perkins S L, Schnitzer B, Hargreaves H, Frizzera G
Department of Pathology, University of Utah Health Sciences Center, Salt Lake City 84109, USA.
Am J Clin Pathol. 1999 Jan;111(1):111-6. doi: 10.1093/ajcp/111.1.111.
Extramedullary plasmacytoma (EMP), solitary plasmacytoma of bone, and multiple myeloma are related neoplasms, but EMP is clearly a distinct entity. Moreover, there are histologic and clinical similarities between EMP and marginal zone B-cell lymphomas (MZLs) displaying extensive plasma cell differentiation, suggesting a possible histogenetic relationship. The histologic and clinical features of 5 EMPs with extensive plasma cell differentiation were histologically reviewed for features of MZL. The previously diagnosed MZLs, mucosa-associated lymphoid tissue (MALT) type, of 2 patients also were reviewed. All patients were women aged 48 to 79 years. The EMPs originated in the parotid gland, lymph nodes, dura, or small bowel. The initial tumors diagnosed as MALT-type MZL were located in the lung and small bowel. All patients were treated with resection, with or without irradiation therapy. One patient also received systemic chemotherapy. All patients are alive with no evidence of disease. All tumors contained large numbers of plasma cells, constituting between 55% and 90% of the lymphoid cells. Centrocyte-like cells and monocytoid B cells each represented 0% to 25% of the infiltrate. Lymphoepithelial lesions were observed in all of the tumors in sites where epithelium was present. Reactive follicles were found in all of the tumors. EMPs may represent MZLs that have undergone an extensive degree of plasmacytic differentiation.
髓外浆细胞瘤（EMP）、骨孤立性浆细胞瘤和多发性骨髓瘤是相关的肿瘤，但EMP显然是一种独特的实体。此外，EMP与显示广泛浆细胞分化的边缘区B细胞淋巴瘤（MZL）在组织学和临床方面存在相似性，提示可能存在组织发生学关系。对5例具有广泛浆细胞分化的EMP进行组织学检查，以观察MZL的特征。还对2例先前诊断为黏膜相关淋巴组织（MALT）型MZL的患者进行了复查。所有患者均为48至79岁的女性。EMP起源于腮腺、淋巴结、硬脑膜或小肠。最初诊断为MALT型MZL的肿瘤位于肺和小肠。所有患者均接受了手术切除，部分患者接受了或未接受放射治疗。1例患者还接受了全身化疗。所有患者均存活，无疾病证据。所有肿瘤均含有大量浆细胞，占淋巴细胞的55%至90%。中心细胞样细胞和单核样B细胞各占浸润细胞的0%至25%。在所有存在上皮的肿瘤部位均观察到淋巴上皮病变。所有肿瘤中均发现反应性滤泡。EMP可能代表已经历广泛程度浆细胞分化的MZL。
