子宫颈单克隆浆细胞增生2例临床病理分析并文献复习  

Cervical monoclonal plasma cell proliferation:a clinicopathological analysis of two cases and review of literature

作　　者：刘祖平 曹棉富 黄娟 孟刚 LIU Zu-ping;CAO Mian-fu;HUANG Juan;MENG Gang(Department of Pathology,First Affiliated Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院病理科,重庆400038

出　　处：《诊断病理学杂志》2024年第4期296-299,303,共5页Chinese Journal of Diagnostic Pathology

基　　金：国家自然科学基金青年科学基金项目(82103590)。

摘　　要：目的探讨2例宫颈单克隆浆细胞增生的临床病理特征、免疫组化特征、分子病理特征及预后。方法对2例宫颈单克隆浆细胞增生进行临床及影像分析、形态学分析、免疫组化染色和分子检测。结果病例1,23岁女性,宫颈黏膜上皮下弥漫浸润不同成熟度的浆细胞,可见多核细胞。病例2,37岁女性,宫颈间质内弥漫浸润具有非典型性的浆样分化的细胞。2例患者影像学均未发现宫颈占位,均显示轻链限制性表达和免疫球蛋白克隆性基因重排,均未进行其他特殊治疗,随访无明显不适。结论宫颈单克隆浆细胞增生是临床罕见的淋巴瘤样病变,常伴轻链限制性表达及免疫球蛋白克隆性基因重排,易被误诊为髓外浆细胞瘤而造成过度治疗。该病预后良好,切除局部病变后随访观察即可。Objective To explore the clinicopathological characteristics,immunohistochemical characteristics,molecular characteristics and the prognosis of two cases of cervical monoclonal plasma cell proliferation.Methods We performed clinical and imaging analyses,morphological analyses,immunohistochemical staining,and molecular detection in two cases of cervical monoclonal plasma cell proliferation.Results Morphologically,the cervical mucosa was diffusely infiltrated with plasma cells of diverse maturity and some multinucleate cells in case one of a 23-year-old female.The cervical stroma was diffusely infiltrated with atypical cells with plasmacytoid differentiation in case two of a 37-year-old female.Both cases showed no radiographic abnormalities,but light chain restriction and clonal immunoglobulin gene rearrangement.No therapy was carried out,and no discomfort was recorded during the follow-up.Conclusion Cervical monoclonal plasma cell proliferation is a rare lymphomatoid disease,with light chain restriction expression and clonal immunoglobulin gene rearrangement.It is easily misdiagnosed as extramedullary plasmacytoma resultsing in overtreatment.The prognosis of this disease is favorable,and follow-up after local resection is recommended.

关 键 词：宫颈肿瘤 单克隆浆细胞增生 髓外浆细胞瘤 淋巴瘤样病变 

分 类 号：R737.33[医药卫生—肿瘤]