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目的探讨鼻腔、鼻窦髓外浆细胞瘤的临床特点与患者预后,以提高对该病的诊断与治疗水平。方法收集2000年1月~2010年11月住院确诊的12例鼻腔、鼻窦浆细胞瘤患者的病历及随访资料,就临床表现、诊断、治疗及预后进行回顾性分析。结果 12例患者中,男9例,女3例,男女比3∶1;35~61岁,平均49.6岁。12例患者均经手术治疗,病理确诊为髓外浆细胞瘤,术后放疗10例,术后放、化疗1例。免疫组化染色排除多发性骨髓瘤,结果显示CD38均为阳性,CD79 a阳性5例,CD20、CD56及Cyc lD1均为阴性。随访1~59个月,平均随访(53±8)个月。术后1年6月及3年各失访1例,术后1年6月局部复发伴重症感染死亡1例,1例术后2年3月转化为多发性骨髓瘤,再行化疗,术后4年死亡。结论鼻腔、鼻窦髓外浆细胞瘤好发于中年男性,诊断主要依靠病理检查,手术+放疗预后较好,部分可转化为多发性骨髓瘤。
Objective To investigate the clinical features and prognosis of extramedullary plasmacytomas in nasal cavity and nasal sinus in order to improve the diagnosis and treatment of the disease. Methods The clinical data and follow-up data of 12 cases of nasal and sinus plasmacytoma diagnosed in hospital from January 2000 to November 2010 were collected retrospectively. The clinical manifestations, diagnosis, treatment and prognosis were retrospectively analyzed. Results Of the 12 patients, 9 were males and 3 were females, with a ratio of men to women of 3: 1; 35-61 years old, with an average of 49.6 years. All the 12 patients were surgically treated with extramedullary plasmacytoma. The postoperative radiotherapy was performed in 10 cases and the postoperative radiotherapy and chemotherapy in 1 case. Immunohistochemical staining to exclude multiple myeloma, the results showed that CD38 are positive, CD79 a positive in 5 cases, CD20, CD56 and Cyc lD1 were negative. The patients were followed up for 1 to 59 months with an average follow-up of 53 ± 8 months. One patient lost one year after operation in June and three years after operation. One patient died of local recurrence and severe infection one year after operation in June and one patient died of severe myeloma after 2 years and 3 months after operation. After 4 years of death. Conclusions Nasal and sinus extramedullary plasmacytomas occur in middle-aged males. The diagnosis mainly depends on the pathological examination. The prognosis of surgery plus radiotherapy is good, and some can be converted into multiple myeloma.