Hu K C, Lin J, Chuang Y C, Cheng S J, Chang K M
Department of Rehabilitation, Mackay Memorial Hospital, 92 North Chung San Road, Sec. 2, Taipei, Taiwan.
J Formos Med Assoc. 2001 Apr;100(4):277-80.
Multiple myeloma associated with extramedullary plasmacytoma at initial presentation is rare. We describe a 45-year-old female patient with an initial presentation of low back pain and right side L5, S1 radiculopathy. There was no evidence of vertebral involvement but an epidural tumor was found later during neurosurgical intervention. The final diagnosis was immunoglobulin G, kappa multiple myeloma complicated with spinal root compression by an extramedullary plasmacytoma. No osteolytic lesion was noted over the length of the spine. Pathology revealed high-grade plasmablastic myeloma. During the clinical course, the patient was refractory to induction chemotherapy, and there was progressive deterioration of renal function. Urinary tract infection by Morganella morganii and pulmonary infection of unknown cause developed 5 months later, and the patient died.
初诊时伴有髓外浆细胞瘤的多发性骨髓瘤很罕见。我们描述了一名45岁女性患者，最初表现为腰痛和右侧L5、S1神经根病。没有椎体受累的证据，但在神经外科手术干预期间后来发现了一个硬膜外肿瘤。最终诊断为免疫球蛋白G、κ型多发性骨髓瘤并发髓外浆细胞瘤压迫脊髓神经根。在整个脊柱长度上未发现溶骨性病变。病理显示为高级别浆母细胞性骨髓瘤。在临床过程中，患者对诱导化疗耐药，肾功能进行性恶化。5个月后发生摩根摩根菌引起的尿路感染和不明原因的肺部感染，患者死亡。
