以头颈部症状首诊的浆细胞瘤7例临床分析及文献复习  

Clinical analysis and literature review of 7 cases of plasmacytoma first diagnosed with head and neck symptoms

作　　者：赵小贤 刘杰[1] 许贞菊[1] 陈丽芳 臧传善[1] 谢枫 白石泽玉 马士慧 韩敏[1] ZHAO Xiaoxian;LIU Jie;XU Zhenju;CHEN Lifang;ZANG Chuanshan;XIE Feng;BAI Shizeyu;MA Shihui;HAN Min(Department of Otorhinolaryngology Head and Neck Surgery,the Affiliated Hospital of Qingdao University,Qingdao,266000,China;Department of Pathology,the Affiliated Hospital of Qingdao University)

机构地区：[1]青岛大学附属医院耳鼻咽喉头颈外科,山东青岛266000 [2]青岛大学附属医院病理科

出　　处：《临床耳鼻咽喉头颈外科杂志》2024年第10期970-974,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨以头颈部症状首诊的浆细胞瘤临床特点、治疗方法和疗效,提高对该疾病的认识,为浆细胞瘤的早期诊断和治疗提供依据。方法:回顾性分析2013年6月-2022年11月青岛大学附属医院收治的7例以头颈部症状首诊的浆细胞瘤患者的临床资料,并结合文献进行复习讨论。结果:7例患者均经组织病理学确诊为浆细胞瘤,病变部位位于鼻咽口咽4例,鼻腔鼻窦2例,室带1例。临床表现及影像学不典型,以局部表现为主,其中2例伴有全身多处骨骼病变,4例淋巴结转移。所有患者均首选手术治疗,术后推荐进行个体化治疗,7例患者中3例行手术+化疗,2例行手术+放疗+化疗,1例行手术+放疗,1例仅行手术治疗。随访时间为3~60个月,随访率100%,5例健在,2例于4~5年死于多发性骨髓瘤。结论:以头颈部症状首诊的浆细胞瘤较为罕见,髓外浆细胞瘤预后较好,而较晚期的多发性骨髓瘤预后较差,因此早期诊断、个体化治疗是提高浆细胞瘤患者生存质量以及生存时间的关键。Objective In order to better understand the condition and provide the groundwork for early detection and treatment of plasmacytomas,it is important to examine the clinical characteristics,therapeutic options,and effectiveness of plasmacytomas that are initially identified with head and neck symptoms.Methods Retrospective analysis,evaluation,and discussion of the clinical data of 7 patients with plasmacytoma initially diagnosed with head and neck symptoms and admitted to the Affiliated Hospital of Qingdao University during the period of June 2013 to November 2022 was done in combination with pertinent literature.Results All seven patients were diagnosed with plasmacytoma by histopathology,with lesions located in the nasopharyngeal oropharynx in 4 cases,nasal sinuses in 2 cases,and ventricular zone in 1 case.Clinical manifestations and imaging were atypical,with localized manifestations,of which 2 cases were accompanied by multiple skeletal lesions throughout the body,and 4 cases had lymph node metastasis.Surgery was preferred for all patients,and individualized treatment was recommended after surgery.Of the 7 patients,3 patients underwent surgery and chemotherapy,2 patients underwent surgery and radiotherapy and chemotherapy,1 patient underwent surgery and radiotherapy,and 1 case was treated with surgery only.The follow-up period was 3-60 months,with a 100%follow-up rate.5 cases were alive and 2 cases died of multiple myeloma after 4-5 yearsConclusion Plasmacytomas first diagnosed with head and neck symptoms are rare,and extramedullary plasmacytomas have a better prognosis,while more advanced multiple myeloma has a poorer prognosis;Therefore,enhancing the quality of survival as well as the duration of survival for patients with plasmacytomas requires early diagnosis and individualized treatment.

关 键 词：头颈部肿瘤 浆细胞瘤 首诊 临床特征 

分 类 号：R739.91[医药卫生—肿瘤]