Yanagimoto Mamiko, Usuki Kensuke, Iijima Kimiko, Hirai Yuji, Iki Seiko, Urabe Akio
Division of Hematology, NTT Kanto Medical Center.
Rinsho Ketsueki. 2003 Jan;44(1):19-24.
An 82-year-old woman was admitted to our hospital because of dizziness and petechiae. Peripheral blood examination showed severe anemia and thrombocytopenia. Bone marrow aspiration revealed 42% leukemic blasts positive for peroxidase with multilineage dysplasia, leading to a diagnosis of acute myeloid leukemia with multilineage dysplasia. The levels of the patient's marrow plasma cells increased to 12%, whereas serum levels of IgG, A, and M dropped. lambda type Bence Jones protein was detected on urine immunoelectrophoresis. The total urinary protein was 3, 960 mg/day. Bone scintigraphy detected multifocal uptake in the ribs. The diagnosis was multiple myeloma developing simultaneously with acute myeloid leukemia. Possible mechanisms for the occurrence of acute myeloid leukemia and multiple myeloma were discussed.
一名82岁女性因头晕和瘀点入住我院。外周血检查显示严重贫血和血小板减少。骨髓穿刺显示42%的白血病原始细胞过氧化物酶呈阳性，伴有多系发育异常，诊断为伴有多系发育异常的急性髓系白血病。患者骨髓浆细胞水平升至12%，而血清IgG、A和M水平下降。尿免疫电泳检测到λ型本-周蛋白。尿总蛋白为3960mg/天。骨闪烁显像检测到肋骨多处摄取。诊断为急性髓系白血病与多发性骨髓瘤同时发生。讨论了急性髓系白血病和多发性骨髓瘤发生的可能机制。
