気管原発の孤立性髄外性形質細胞しゅの１例

Abstract

A rare case of recurrent solitary extramedullary plasmacytoma of the trachea is reported.A 52-year-old woman with the complaint of cough and dyspnea of three months' duration was referred to our hospital by an otolaryngologist for diagnosis and treatment. The patient had the same symptoms 13 years before. The tracheal tumor was found at the level of the first and the second tracheal rings by various examinations. It was extirpated with laryngofissure. The tumor did not destroy the tracheal cartilage. The histopathological examination of the specimen revealed a lymphomatous tumor at that time.This time, endoscopic examinations and CT scanning revealed the tumor occurred at the same place as before, invading to the outside of the trachea. Then tracheostomy, laryngoscopy and reduction surgery were performed. The histological section of the tumor showed an extramedullary plasmacytoma. The blood examination showed a slight iron deficient anemia, but urinary Bence-Jones protein and myeloma protein were not detected. There was no abnormal 67Ga uptake in the whole body. The endotracheal reduction surgery and 60Co irradiation of 6000 rads could control the endotracheal tumor, however, they did not reduce the extratracheal lesion because of its radioresistance. The patient refuses the total removal of the tumor, so she is followed up regularly at the outpatient clinic.The symptoms and the nature of the solitary extramedullary plasmacytoma and its relation to plasma cell tumor are discussed.