Joung C I, Kang T Y, Park Y W, Lee W S, Lee Y Y, Park M H, Joo K B, Yoo D H
Department of Rheumatology, Konyang University Hospital, Daejeon, Korea.
Scand J Rheumatol. 2005 Mar-Apr;34(2):152-4. doi: 10.1080/03009740510026355.
We report a case with protruding inguinal masses for 6 months, in whom muscular amyloidoma was not suspected before muscle biopsy. On pelvic magnetic resonance imaging (MRI), round masses showing peripheral rim enhancement with gadolinium were observed in iliopsoas and iliacus muscles of both inguinal areas. The same lesions were also observed in gluteus muscles. The biopsy showed Congo red positive materials in a dense fibrous background. Serum and urine electrophoresis showed Bence Jones protein, lambda type. In bone marrow section, myeloma cells were found. Peripheral blood stem cell transplantation (PBSCT) following four cycles of VAD (vincristine, adriamycin, dexamethasone) chemotherapy was performed and the result was satisfactory. Amyloidoma lesions decreased in size and number on the following MRI.
我们报告一例腹股沟肿块突出6个月的病例,在肌肉活检前未怀疑有肌肉淀粉样瘤。盆腔磁共振成像(MRI)显示,双侧腹股沟区的髂腰肌和髂肌中有圆形肿块,钆增强后呈周边环形强化。臀肌中也观察到同样的病变。活检显示在致密纤维背景中有刚果红阳性物质。血清和尿液电泳显示为λ型本-周蛋白。骨髓切片中发现了骨髓瘤细胞。在进行四个周期的VAD(长春新碱、阿霉素、地塞米松)化疗后进行了外周血干细胞移植(PBSCT),结果令人满意。在随后的MRI检查中,淀粉样瘤病变的大小和数量均减少。