Solitary plasmacytoma of the carina.
نویسنده
چکیده
A 69-year-old woman was admitted with a three-week ;i` history of shortness of breath and wheezing accompanied by infrequent small haemoptyses. She had been treated at home for asthma with bronchodilators, and steroids, but had shown no improvement. She had stridor but no other added sounds in the chest. Systematic examination was normal. A blood 4 count and film were normal. ESR was 40 mm/min. Urea, electrolytes, and liver function tests were nor* * mal. Protein electrophoresis showed a discrete band in the gamma region but immunoelectrophoresis showed normal immunoglobulin levels and no mono' clonal band. Urine contained no Bence-Jones protein. Fig 1 Biopsy specimen f1 Sternal marrow was normal with no excess of plasma compact masses of plasm cells. Chest radiograph and tomograms of the trachea showed a lobulated mass at the carina, which was confirmed by bronchoscopy. A biopsy specimen taken at bronchoscopy showed normal epithelium with heavy submucosal infiltration by compact masses of plasma cells (fig 1). The features were those of a plasmacytoma. In 1959 this patient had been seen in the ENT department complaining of hoarseness, and a prolapse of the right laryngeal ventricle and small areas of lymphoid tissue in the nasopharynx had been found. Histology of these areas showed multiple small plasma cell tumours. A course of radiotherapy to the affected area resulted in rapid disappearance of the lesions. The next year small plasmacytomas recurred on both right and left sides of the nasopharynx and on the roof of the soft palate, and these again disappeared with radiotherapy. Comparison of the biopsy from the carinal lesion with slides from the earlier biopsies from the nasopharynx (fig 2) showed the histology to be identical. The carinal tumour was first treated by radiotherapy but two weeks after completion of treatment her stridor was still present and further tomography showed no significant change in tumour size. This was confirmed at a second bronchoscopy when a Fig 2 Biopsy specimen fr large portion of tumour was removed via the removed in 19s9, showing bronchoscope. carinal lesion (X1000). rom carinal tumour, showing a cells (X 1000).
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ورودعنوان ژورنال:
- Thorax
دوره 34 4 شماره
صفحات -
تاریخ انتشار 1979