Bhandari Meghana S, Mazumder Amitabha, Vesole David H
St. Vincent's Comprehensive Cancer Center, New York, NY 10011, USA.
Clin Lymphoma Myeloma. 2007 Sep;7(8):538-40. doi: 10.3816/clm.2007.n.039.
Clinical manifestations of liver involvement in multiple myeloma (MM) are uncommon. Rare cases of MM present as acute liver disease. We report a case of a 55-year-old woman with MM who presented with painless jaundice, mild pruritus, and abnormal liver function tests resembling acute cholestatic hepatitis without the stigmata of chronic liver disease. Initial laboratories included elevated liver function tests (aspartate aminotransferase 74 U/L and alanine aminotransferase 45 U/L) and an elevated white blood cell count of 19,600 cells/microL with 33% circulating plasma cells. Myeloma parameters demonstrated an immunoglobulin G lambda monoclonal protein with lambda light-chain Bence-Jones proteinuria. Bone marrow was hypercellular with 70% plasmacytosis. A liver biopsy revealed a diffuse portal and sinusoidal infiltration of plasma cells with lambda light-chain restriction. In this report, we review the literature of liver involvement in MM.
多发性骨髓瘤（MM）累及肝脏的临床表现并不常见。罕见的MM病例表现为急性肝病。我们报告一例55岁患有MM的女性，她表现为无痛性黄疸、轻度瘙痒，以及肝功能检查异常，类似于急性胆汁淤积性肝炎，且无慢性肝病的体征。初始实验室检查包括肝功能检查升高（天冬氨酸转氨酶74 U/L，丙氨酸转氨酶45 U/L），白细胞计数升高至19,600个/微升，循环浆细胞占33%。骨髓瘤参数显示免疫球蛋白G λ单克隆蛋白伴λ轻链本-周蛋白尿。骨髓细胞增多，浆细胞增多达70%。肝脏活检显示浆细胞弥漫性浸润门静脉和肝血窦，伴λ轻链限制。在本报告中，我们回顾了MM累及肝脏的文献。
