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#author("2024-05-30T19:48:14+09:00","","") #author("2024-05-30T19:50:37+09:00","","") [[Plasma cell dyscrasia]] *extramedullary plasmacytoma arising in the sinonasal tract [#y911793e] 71year old, male //H1104919_1995665 //&photo(PCnose01.jpg); ***鼻腔内腫瘤生検組織 病理所見 [#s1462b88] #gallery(left,nowrap,noadd){{ PCnose01.jpg>CT PCn01.jpg>HE PCn03.jpg>HE Giemsa01.jpg>Giemsa染色 }} //&photo(PCn03.jpg); &photo(PCn01.jpg); &photo(Giemsa01.jpg); サムネイルをクリックすると大きな画像が見られます。 #br ''免疫染色'' #gallery(left,nowrap,noadd){{ CD38.jpg>CD38 CD138.jpg>CD138 CD56.jpg>CD56 LCA.jpg>CD45(LCA) }} //|&photo(CD38.jpg);|&photo(CD138.jpg);|&photo(CD56.jpg);|&photo(LCA.jpg);| //|CENTER:CD38|CENTER:CD138|CENTER:CD56|CENTER:LCA(CD45)| ***''plasmacytoma'' [#ic879db9] WHO 5th classification ---plasmacytoma &ref(形質細胞腫.txt); WHO 5th classification ---plasmacytoma &ref(形質細胞腫-WHO 5th classification.txt); 形質細胞腫は, &color(#0000ff){''形質細胞(多発性)骨髄腫をともなわない, または形質細胞腫瘍による末端臓器障害を伴わない''};形質細胞のクローン性孤立性新生物である。（WHO5th classification) >形質細胞腫のサブタイプ >1. solitary plasmacytoma of the bone（SPB） >2. ''extramedullary plasmacytoma of the soft tissue''（EMP） -plasma cell neoplasmの5%未満で、%%%その80%は''head & neckに発生''する.%%% #br -鼻腔腫瘍のおよそ4%をしめ, 頭頸部悪性腫瘍の0.4%にあたる。 #br -診断のクライテリア¬e{:Souter R, et al. Guidelines on the diagnosis and management of solitary plasmacytoma of bone and solitary extramedullary plasmacytoma. Br J Haematol 2004; 124: 717-726}; --単一髄外病変にモノクロナールな形質細胞増殖を病理学的に証明する --&color(#0000ff){''骨髄病変はない。''}; --サーベイで骨病変はみつからない --plasma cell dyscresiaによる貧血, 高カルシウム血症, 腎病変を認めない。 --monoclonal immunoglobulinは低レベル。血清/尿中 Mタンパクが検出されるのは患者さんの1/4未満。 > solitary plasmacytoma of the boneは主に造血が活発な骨に発生し、''付属骨格よりも軸骨格を侵すことが多い。脊椎が最もよく侵され''、骨盤、肋骨、頭蓋骨および長骨がそれに続く¬e{:Warsame R, Gertz MA, Lacy MQ, et al. Trends and outcomes of modern staging of solitary plasmacytoma of bone. Am J Hematol. 2012 Jul;87(7):647-51. PMID: 2254979};¬e{:Suh YG, Suh CO, Kim JS, et al. Radiotherapy for solitary plasmacytoma of bone and soft tissue: outcomes and prognostic factors. Ann Hematol. 2012 Nov;91(11):1785-93. PMID: 22752147.};¬e{:Shen X, Liu S, Wu C, et al.Survival trends and prognostic factors in patients with solitary plasmacytoma of bone: A population-based study. Cancer Med. 2021 Jan;10(2):462-470. PMID: 33145987};¬e{:Alghisi A, Borghetti P, Maddalo M, et al. Radiotherapy for the treatment of solitary plasmacytoma: 7-year outcomes by a mono-institutional experience. J Cancer Res Clin Oncol. 2021 Jun;147(6):1773-1779.PMID: 33201300.};。 > extramedullary plasmacytoma of the soft tissueは、上気道（鼻腔、副鼻腔、上咽頭、喉頭）に発生することが最も多い¬e{33201300:Alghisi A, Borghetti P, Maddalo M, et al. Radiotherapy for the treatment of solitary plasmacytoma: 7-year outcomes by a mono-institutional experience. J Cancer Res Clin Oncol. 2021 Jun;147(6):1773-1779.PMID: 33201300.};¬e{:Alexiou C, Kau RJ, Dietzfelbinger H,et al. Extramedullary plasmacytoma: tumor occurrence and therapeutic concepts. Cancer. 1999 Jun 1;85(11):2305-14. PMID: 10357398.};¬e{:Kremer M, Ott G, Nathrath M, et al. Primary extramedullary plasmacytoma and multiple myeloma: phenotypic differences revealed by immunohistochemical analysis. J Pathol. 2005 Jan;205(1):92-101.PMID: 15586381.};¬e{:Agbuduwe C, Yang H, Gaglani J, Ajithkumar T. Clinical presentation and outcomes of solitary plasmacytoma in a tertiary hospital in the UK. Clin Med (Lond). 2020 Sep;20(5):e191-e195.PMID: 32934063};まれにリンパ節¬e{15586381:Kremer M, Ott G, Nathrath M, et al. Primary extramedullary plasmacytoma and multiple myeloma: phenotypic differences revealed by immunohistochemical analysis. J Pathol. 2005 Jan;205(1):92-101.PMID: 15586381.};¬e{10357398:Alexiou C, Kau RJ, Dietzfelbinger H,et al. Extramedullary plasmacytoma: tumor occurrence and therapeutic concepts. Cancer. 1999 Jun 1;85(11):2305-14. PMID: 10357398.};¬e{11190797:Menke DM, Horny HP, Griesser H, Tiemann M, Katzmann JA, Kaiserling E, Parwaresch R, Kyle RA. Primary lymph node plasmacytomas (plasmacytic lymphomas). Am J Clin Pathol. 2001 Jan;115(1):119-26. doi: 10.1309/L2GR-PCFM-G4A3-GHDW. PMID: 11190797.};、肺、消化管¬e{10357398:Alexiou C, Kau RJ, Dietzfelbinger H,et al. Extramedullary plasmacytoma: tumor occurrence and therapeutic concepts. Cancer. 1999 Jun 1;85(11):2305-14. PMID: 10357398.}; ¬e{28056880:Thumallapally N, Meshref A, Mousa M, Terjanian T. Solitary plasmacytoma: population-based analysis of survival trends and effect of various treatment modalities in the USA. BMC Cancer. 2017 Jan 5;17(1):13. Erratum in: BMC Cancer. 2017 Jun 23;17 (1):443. PMID: 28056880};泌尿生殖器¬e{10357398:Alexiou C, Kau RJ, Dietzfelbinger H,et al. Extramedullary plasmacytoma: tumor occurrence and therapeutic concepts. Cancer. 1999 Jun 1;85(11):2305-14. PMID: 10357398.};¬e{15586381:Kremer M, Ott G, Nathrath M, et al. Primary extramedullary plasmacytoma and multiple myeloma: phenotypic differences revealed by immunohistochemical analysis. J Pathol. 2005 Jan;205(1):92-101.PMID: 15586381.};皮膚¬e{10357398:Alexiou C, Kau RJ, Dietzfelbinger H,et al. Extramedullary plasmacytoma: tumor occurrence and therapeutic concepts. Cancer. 1999 Jun 1;85(11):2305-14. PMID: 10357398.};¬e{:Comfere NI, Gonzalez Santiago TM, Peters MS, Knudson RA, Ketterling RP, Gibson LE. Cutaneous extramedullary plasmacytoma: clinical, prognostic, and interphase cytogenetic analysis. Am J Dermatopathol. 2013 May;35(3):357-63.PMID: 23000906.};を侵す。
