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目的探讨髓外浆细胞瘤(Extra-medullary Plasmacytoma,EMP)的诊断及治疗。方法回顾性分析我科10年来收治的3例鼻腔、2例鼻咽、1例鼻窦EMP的临床资料,结合文献对其临床表现、病理特点、鉴别诊断及治疗进行探讨。结果6例病人中3例鼻腔EMP病人单纯手术治疗,2例鼻咽部EMP病人行单纯放疗,1例鼻窦EMP病人手术后放疗。随访2~11年,其中1例鼻咽部病人放疗后6年死于肺部感染,1例鼻窦EMP病人于放疗1年后失访,其余4例随访至今未见复发。结论EMP是少见的低度恶性肿瘤,依据临床和组织学特点,结合免疫组化可明确诊断,放疗和手术是治疗EMP主要方法。
Objective To investigate the diagnosis and treatment of extra-medullary plasmacytoma (EMP). Methods The clinical data of 3 cases of nasal cavity, 2 cases of nasopharynx and 1 case of sinusitis treated in our department over the past 10 years were retrospectively analyzed. The clinical manifestations, pathological features, differential diagnosis and treatment of sinusitis were analyzed. Results In 6 patients, 3 cases of nasal EMP were treated by surgery alone, 2 cases of nasopharyngeal EMP were treated by radiotherapy alone and 1 case of sinus EMP after operation. Follow-up ranged from 2 to 11 years. One of the nasopharyngeal patients died of pulmonary infection at 6 years after radiotherapy. One case of sinusitis EMP was lost one year after radiotherapy and the other 4 cases had no recurrence. Conclusion EMP is a rare low-grade malignant tumor. According to the clinical and histological features, immunohistochemistry can confirm the diagnosis, radiotherapy and surgery are the main methods of EMP.