上咽頭に発生した髄外性形質細胞腫例 Extramedullary Plasmacytoma of the Epipharynx : A Case Report
We report a case of extramedullary Plasmacytoma of the epipharynx in an 80-year-old woman. She complained of a sensation of occlusion in the epipharynx. Physical examination, computed tomography, and magnetic resonance imaging showed a mass measuring 15mm in diameter in the epipharynx without associated cervical lymphadenopathy. Biopsy of the lesion showed extramedullary plasmacytoma. There were no abnormalities with respect to serum immunoglobulin levels, serum or urinary protein levels, or bone marrow biopsy findings. Surgical resection of the tumor was performed by the endoscopic transnasal method with a CO<sub>2</sub> laser. Immunohistochemical examination of the resected mass demonstrated monoclonality for immunoglobulin heavy-chain IgG and lambda-light chain in the tumor cells. Additionally, a rearrangement band was identified on Southern blot analysis of tumor extract using the probe for imunoglobulin heavy chain.<br>Because the surgical margin was positive for tumor cells, additional resection was performed. However, there was no apparent tumor in the further resected tissue specimen. There has not been any sign of local recurrence or development of multiple myeloma 13 months after surgery.<br>We suggest that surgery is the optimal choice for treating extramedullary plasmacytoma of the head and neck when the tumor is localised and resectability is good.
耳鼻咽喉科臨床 101(6), 445-452, 2008-06-01
The Society of Practical Otolaryngology