硼替佐米治疗髓外结肠浆细胞瘤1例并文献复习.docVIP

精品论文 参考文献 硼替佐米治疗髓外结肠浆细胞瘤1例并文献复习 谢晓艳 王方方 孙爱红 管俊（通讯作者） 　　（江苏省扬州市苏北人民医院血液科 江苏扬州 225000） 　　【摘要】浆细胞瘤是一种少见的恶性肿瘤，髓外浆细胞瘤中结肠浆细胞瘤的发生率更低。本文报告了一例67岁女性患者，以腹痛起病，肠镜提示降结肠病变，病理提示浆细胞瘤，其余血清M蛋白、肝肾功能、骨髓、骨影像学检查均阴性，诊断原发性结肠髓外浆细胞瘤，应用硼替佐米联合地塞米松、环磷酰胺治疗，化疗后死于感染并发症。本文总结讨论了文献报道的31例患者，多以腹痛、血便起病，其中原发性髓外浆细胞瘤对手术、放疗疗效佳，预后好；而继发于多发性骨髓瘤的结肠浆细胞瘤则预后差。文献报道硼替佐米治疗髓外浆细胞瘤疗效佳，还有待积累更多的临床研究。 　　【关键词】髓外浆细胞瘤；结肠；硼替佐米 　　【中图分类号】R730.5 【文献标识码】A 【文章编号】1007-8231（2015）12-0145-03 　　【Abstract】Plasmacytoma is a rare malignant tumor , but the incidence of the colonic extramedullary plasmacytomas is more lower. We report a case of 67-year-old female patient with abdominal pain onset. The colonoscopy examination revealed descending colon lesions, which was biopsied. Pathological evaluation showed plasmacytoma. The other laboratory tests including M protein, renal profile, and liver function test results normalized. Bone marrow aspiration and bone emission computed tomographywere within normal limits.A diagnosis, therefore, was made of extramedullary plasmacytoma of the colon.After she was administerated with bortezomib, cyclophosphamide and dexamethasone, she died of infection complications.The text also summarized and discussed 31 cases reported in literatures who complained of abdominal pain and bloody stool. Primary colonic extramedullary plasmacytomas can be treated with local therapy (radiation, resection); however, multiple myeloma with secondary colonic extramedullary plasmacytomas is suggestive of aggressive disease with a poor outcome. Mentioned in the literatures, plasmacytomas are successfully treated with bortezomib-containing chemotherapy. Longer follow‐up and larger number of patients is needed to interpret the result and survival and to determine the proper line of management. 　　【Key words】Medullary plasmacytomas;Colon;Bortezomib 　　浆细胞瘤是由浆细胞异常增生而形成的肿瘤，是一种少见的恶性肿瘤，可分为多发性骨髓瘤、孤立性骨浆细胞瘤、浆细胞性白血病和髓外浆细胞瘤等4种类型[1]。约80%的髓外浆细胞瘤发生于上呼吸道，包括口腔部、鼻咽部、鼻窦和喉，但也可发生于许多其他部位，如胃肠道、淋巴结、膀胱、中枢神经、乳腺、甲状