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摘要: 报告1例喉髓外浆细胞瘤。患者持续声音嘶哑伴咽部异物感5个月。喉镜提示左侧喉前庭包块，左杓会厌襞膨隆。颈部影像学提示声门左侧壁增厚呈肿块样改变，部分突向喉腔，喉室变窄，向外突破甲状软骨生长，向上达舌骨水平。完善检查后于全身麻醉支撑喉镜下行喉新生物切除术+活检术。病理提示喉上皮下纤维组织见小细胞弥漫增生，局部呈列兵样，可见异型及核分裂象，结合免疫组织化学结果，符合浆细胞瘤。Abstract: This paper reported a case of extramedullary plasmacytoma of the larynx. The patient presented with persistent hoarseness and foreign body sensation in pharynx for 5 months. Left anterior laryngeal mass, left epiglottis fold distention was found during laryngoscopy. Cervical image examination showed that the left side wall of the glottis was thickened and showed a lump-like change, part of which protrusion into the laryngeal cavity, the laryngeal chamber became narrow, and the growth of thyroid cartilage was broken outwards and reached the level of the hyoid bone. After completing the examination, the laryngeal tumor resection and biopsy were performed under the suspension laryngoscope. Pathologic findings showed that diffuse proliferation of small cells was observed in laryngeal subepithelial fibrous tissue, with local appearance of private, atypia and mitosis. Combined with immunohistochemical results, it was consistent with plasma cell tumor.
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图 1 喉镜检查 1a：术前喉镜示左侧喉前庭包块遮挡声门区，左杓会厌襞膨隆; 1b：术后4个月复查喉镜，示双侧声带肿胀; 1c：术后1年复查喉镜，示左声带前份局部粘连，右声带肥厚; 图 2 影像学检查 2a：术前颈部CT示声门左侧壁增厚呈肿块样改变，考虑肿瘤样病变，部分突向喉腔，喉室变窄，向外突破甲状软骨生长，向上达舌骨水平; 2b：术后6个月复查颈部CT，见声门左侧壁、双侧杓会厌皱襞增厚，伴双侧梨状隐窝狭窄，相应喉室变窄，考虑术后改变; 2c：术后14个月复查PET-CT，示全身骨多发骨质破坏并软组织密度影，代谢活性增高，考虑转移; 图 3 术后病理检查 小细胞弥漫增生，可见异型及核分裂象，结合免疫组织化学结果符合浆细胞瘤。
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