Fujii H, Yashige H, Taniwaki M, Urata Y, Kuzuyama Y, Kitagawa Y, Horishi M, Suyama Y, Miyoshi M
3rd Dept. of Int. Med. Kyoto First Red Cross Hospital.
Gan No Rinsho. 1990 Apr;36(5):645-50.
A 71-year-old man was hospitalized in November, 1983 for a back pain and a diagnosis of multiple myeloma was made, based on the Bence Jones proteinuria, The serum M-component of a IgG-kappa type (3.3 g/dl), and plasmacytosis in the bone marrow (37%). Treatment consisted of melphalan and prednisolone. A blood count in March, 1986 revealed 6000/microliters of WBC with 30% of a blast form and 8% plasma cells, and 20,000/microliters of platelets. A bone marrow aspirate revealed that 14% were myeloblasts and 26% were plasma cells. Distinguishing the myeloblasts from the immature plasma cells in the peripheral blood proved difficult. Studies by electron microscopy and an immunological inspection of phenotypes were helpful in achieving a determination. A karyotypic analysis of the bone marrow cells indicated a hypodiploid cell population, a marker chromosome, and a karyotypic instability. These findings indicate that his multiple myeloma had undergone a leukemic change associated with acute myelogenous leukemia.
一名71岁男性于1983年11月因背痛住院，根据本周蛋白尿、IgG-κ型血清M蛋白成分（3.3g/dl）以及骨髓中的浆细胞增多（37%），诊断为多发性骨髓瘤。治疗包括美法仑和泼尼松龙。1986年3月的血常规显示白细胞计数为6000/微升，其中原始细胞占30%，浆细胞占8%，血小板计数为20000/微升。骨髓穿刺显示14%为原始粒细胞，26%为浆细胞。在外周血中区分原始粒细胞和未成熟浆细胞很困难。电子显微镜研究和表型的免疫检查有助于做出诊断。骨髓细胞的核型分析显示为亚二倍体细胞群、一条标记染色体和核型不稳定。这些发现表明他的多发性骨髓瘤已发生与急性髓系白血病相关的白血病转化。
