Head and Neck Extramedullar Plasmacytoma.

İmdat Yüce, Nezaket Tektaş, Mete Gündoğ, Özlem Canöz, Mehmet Can Kaya, Sedat Çağlı
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Abstract

Purpose: This study aimed to contribute to the literature by sharing experience of head-neck extramedullary plasmacytoma (EMP), which are rarely seen.

Methods: A total of 11 patients treated for head and neck region EMP between 2000 and 2023 were screened retrospectively.

Results: The 11 patients comprised 9 men and 2 women with a mean age of 55.1 ± 16.2 (range, 16-74) years. The most affected regions were seen to be the sinonasal tract, larynx, and tonsils. In the histopathological examination, plasma cells had a mature or anaplastic appearance, and one of the kappa and lambda light chains was positive and the other was completely negative. The serum electrophoresis and bone marrow flow cytometry results were negative. Of the patients with confirmed EMP diagnosis, 8 were treated with radiotherapy (RT) alone, 1 patient with maxillectomy, and 1 patient endoscopic sinus surgery followed by RT. RT was applied at a dose of 44 to 50 Gy for 22 to 25 sessions. In 1 patient, RT and chemotherapy were applied together.

Conclusion: In cases presenting with a submucosal, destructive tumor in the head and neck region, especially in the sinonasal region, EMP should be kept in mind. When histopathological results are confirmed, a differential diagnosis from multiple myeloma (MM) is required. Flow cytometry is of guidance in the differentiation of EMP from extranodal lymphoma. However, it should be noted that the effect of RT may be less in EMPs originating from the paranasal sinus compared with other anatomic regions, and surgery may be required before or after RT. A radiation dose of 45 Gy is sufficient for local control. Patients require long-term follow-up, as there is a possibility of EMP transforming to MM.

头颈部髓外浆细胞瘤。
目的:本研究旨在通过分享头颈部少见的髓外浆细胞瘤(EMP)的经验,为文献做出贡献。方法:对2000 ~ 2023年间11例头颈部EMP患者进行回顾性分析。结果:11例患者男9例,女2例,平均年龄55.1±16.2岁(范围16 ~ 74岁)。最受影响的区域是鼻道、喉部和扁桃体。在组织病理学检查中,浆细胞表现为成熟或间变性,kappa和lambda轻链一条阳性,另一条完全阴性。血清电泳及骨髓流式细胞术结果均为阴性。在确诊EMP的患者中,8例单独放疗,1例上颌切除,1例内镜鼻窦手术后放疗。放疗剂量为44 ~ 50 Gy,持续22 ~ 25次。1例患者同时应用放疗和化疗。结论:在头颈部,特别是鼻窦区出现粘膜下、破坏性肿瘤的病例中,应注意电磁脉冲。当组织病理学结果得到证实时,需要与多发性骨髓瘤(MM)鉴别诊断。流式细胞术对EMP与结外淋巴瘤的鉴别具有指导意义。然而,应该注意的是,与其他解剖区域相比,放射治疗对鼻窦产生的emp的影响可能较小,并且可能需要在放射治疗之前或之后进行手术。45gy的辐射剂量足以局部控制。患者需要长期随访,因为有可能EMP转化为MM。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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