Kim Nae Yu, Gong Soo Jung, Kim Jimyung, Youn Seon Min, Lee Jung-Ae
Department of Internal Medicine, Eulji University Hospital, 1306 Dunsan-dong, Seo-gu, Daejeon, Korea.
Korean J Lab Med. 2011 Oct;31(4):285-9. doi: 10.3343/kjlm.2011.31.4.285. Epub 2011 Oct 3.
We report a rare case of multiple myeloma with biclonal gammopathy (IgG kappa and IgA lambda type) in a 58-year-old man with prostate cancer who presented with lower back pain. Through computed tomography (CT) imaging, an osteolytic lesion at the L3 vertebra and an enhancing lesion of the prostate gland with multiple lymphadenopathies were found. In the whole body positron emission tomography-computed tomography (PET-CT), an additional osteoblastic bone lesion was found in the left ischial bone. A prostate biopsy was performed, and adenocarcinoma was confirmed. Decompression surgery of the L3 vertebra was conducted, and the pathologic result indicated that the lesion was a plasma cell neoplasm. Immunofixation electrophoresis showed the presence of biclonal gammopathy (IgG kappa and IgA lambda). Bone marrow plasma cells (CD138 positive cells) comprised 7.2% of nucleated cells and showed kappa positivity. We started radiation therapy for the L3 vertebra lesion, with a total dose of 3,940 cGy, and androgen deprivation therapy as treatment for the prostate cancer.
我们报告了一例罕见的58岁前列腺癌男性患者，其患有双克隆丙种球蛋白病（IgG κ和IgA λ型），表现为下背部疼痛。通过计算机断层扫描（CT）成像，发现L3椎体有溶骨性病变，前列腺有强化病变并伴有多处淋巴结肿大。在全身正电子发射断层扫描 - 计算机断层扫描（PET - CT）中，左侧坐骨发现了一处成骨性骨病变。进行了前列腺活检，确诊为腺癌。对L3椎体进行了减压手术，病理结果表明该病变为浆细胞肿瘤。免疫固定电泳显示存在双克隆丙种球蛋白病（IgG κ和IgA λ）。骨髓浆细胞（CD138阳性细胞）占核细胞的7.2%，且呈κ阳性。我们开始对L3椎体病变进行放射治疗，总剂量为3940 cGy，并对前列腺癌进行雄激素剥夺治疗。
