纵隔粒细胞肉瘤一例报告并文献复习

摘要

目的 探讨纵隔粒细胞肉瘤(granulocytic sarcomas,GS)的临床特点及诊疗措施,提高对其认识.方法 回顾性分析我院确诊的1例纵隔GS的临床资料并复习相关文献.结果 患者因左上肢肿胀2周入院,胸部CT检查示下颈部左侧、左侧锁骨及左侧前上纵隔多处不规则软组织肿块影,进一步行淋巴结B超检查、纵隔肿瘤活检术、骨髓活检及流式细胞检测确诊纵隔GS.予MA(米托蒽醌+阿糖胞苷)方案化疗,病情缓解.结论 纵隔GS十分罕见,易误诊为淋巴瘤,病理组织学检查是其诊断金标准,MPO和CD68是诊断G5敏感的标志物.%Objective To discuss the clinical characteristics and treatment of mediastinal granulocytic sarcoma (CS). Methods Clinical data of one case with mediastinal GS was retrospectively analyzed. We also reviewed pertinent literatures. Results The patient was admitted for left upper extremity tumescence for 2 weeks. Chest CT revealed left lower neck, left clavicle and left anterosuperior mediastinum with multiple irregular soft tissue mass. The patient underwent further examination of the lymph nodes type-B ultrasonic, the mediastinal tumor biopsy, bone marrow biopsy, flow cytomerric analysis, and mediastinal GS was confirmed. The patient recovered quickly after chemotherapy with MA ( Mitoxantrone + Cytarabine). Conclusion Mediastinum GS is rare, and may be easily misdiagnosed as lymphoma. Histopathologic examination is the golden standard in mediastinum GS diagnosis. MPO and CD68 are the susceptible markers for diagnosing GS.