Dachs Robert, Horn Anria, Koornhof Hannes, de Jager Louis, Maqungo Sithombo, Roche Stephen
Department of Orthopaedic Surgery, University of Cape Town, Cape Town, South Africa.
Division of Clinical Haematology, University of Cape Town, Cape Town, South Africa.
J Bone Oncol. 2014 Mar 14;3(2):61-5. doi: 10.1016/j.jbo.2014.02.002. eCollection 2014 May.
The association of sarcoidosis with multiple myeloma is not well known. Including this case report, 12 cases of patients with both sarcoidosis and multiple myeloma have been reported in the literature. The skeletal lesions of both conditions have many clinical and radiological similarities, and unless clinicians are aware of the association and the possibility of dual pathologies, the diagnosis of multiple myeloma in patients known with sarcoidosis may be missed. We present a case of a patient known with longstanding sarcoidosis who was found to have multiple lesions on magnetic resonance imaging (MRI) involving the pelvis and both proximal femurs. Histological analysis revealed the presence of both non-necrotising granulomas consistent with sarcoidosis, and sheets of plasma cells consistent with a plasma cell neoplasm.
结节病与多发性骨髓瘤的关联并不为人熟知。包括本病例报告在内，文献中已报道了12例同时患有结节病和多发性骨髓瘤的患者。这两种疾病的骨骼病变在临床和影像学上有许多相似之处，除非临床医生了解这种关联以及双重病理的可能性，否则已知患有结节病的患者可能会漏诊多发性骨髓瘤。我们报告一例长期患有结节病的患者，其在磁共振成像（MRI）检查中发现骨盆和双侧股骨近端有多处病变。组织学分析显示既有符合结节病的非坏死性肉芽肿，也有符合浆细胞瘤的成片浆细胞。
