von Keyserlingk H, Baur R, Stein H, Hoeffken G, Thiel E
FU Klinikum Steglitz, Abteilung für Innere Medizin mit, Berlin, Federal Republic of Germany.
Cancer Detect Prev. 1990;14(3):403-4.
An increased incidence of tumors and B-cell lymphomas development has been reported in persons with or at risk for acquired immunodeficiency syndrome (AIDS). This report focuses on a 50-year-old homosexual man with HIV antibodies who met the established criteria for the diagnosis of multiple myeloma: an IgG monoclonal spike greater than 2 g/dl and a plasma cell count greater than 20% in the bone marrow aspirate. Serum protein immunoelectrophoresis showed monoclonal IgG kappa, and in the urine no excess of kappa chains was found. Laboratory data revealed a total IgG of 38 g/l, IgA of 5.2 g/l, and IgM of 2.3 g/l; the calcium level was normal; ESR was 119/130, and no plasmocytoid cells were seen in the differential count. No lytic lesions were found in the skeletal survey. The helper/suppressor T-cell ratio was depleted with 0.1 and HLA-DR was highly elevated with 56% in the immunofluorescent analysis. The development of the most differentiated B-cell tumor broadens the spectrum of B-cell neoplasias in patients with a predominant helper T-cell defect and focuses on the role of disordered immunoregulation and chronic antigenic stimulation in predisposing to B-cell malignant transformation associated with AIDS.
据报道，患有获得性免疫缺陷综合征（AIDS）或有患该综合征风险的人群中，肿瘤和B细胞淋巴瘤的发病率有所增加。本报告聚焦于一名50岁的同性恋男子，其HIV抗体检测呈阳性，符合多发性骨髓瘤的既定诊断标准：骨髓穿刺液中IgG单克隆峰大于2g/dl且浆细胞计数大于20%。血清蛋白免疫电泳显示单克隆IgG κ，尿液中未发现κ链过量。实验室数据显示，总IgG为38g/l，IgA为5.2g/l，IgM为2.3g/l；钙水平正常；血沉为119/130，分类计数中未见浆细胞样细胞。骨骼检查未发现溶骨性病变。免疫荧光分析显示辅助/抑制性T细胞比值降至0.1，HLA-DR高度升高至56%。最分化的B细胞肿瘤的发生拓宽了以辅助性T细胞缺陷为主的患者中B细胞肿瘤的谱，并着重关注免疫调节紊乱和慢性抗原刺激在易患与艾滋病相关的B细胞恶性转化中的作用。
