Kusaba Kana, Kojima Kensuke, Naito Shinji, Taba Mitsuru, Kai Keita, Ureshino Hiroshi, Nishida Yuki, Kimura Shinya
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan.
Department of Pathology, National Hospital Organization Ureshino Medical Center, Japan.
Intern Med. 2017;56(15):2049-2051. doi: 10.2169/internalmedicine.56.8331. Epub 2017 Aug 1.
Sarcoidosis predominantly affects the lungs, intrathoracic lymph nodes, and eyes; it less frequently affects the musculoskeletal system. We herein report a case of paraneoplastic sarcoidosis in a patient presenting with multiple myeloma. The patient developed ocular sarcoidosis and showed an increased F-fluorodeoxyglucose uptake in the mediastinal lymph nodes and vertebral column. A lymph node specimen showed the histological features of sarcoidosis, while an examination of the vertebral tumor revealed myeloma. Although the simultaneous occurrence of sarcoidosis and myeloma is extremely rare, our case indicates the importance of exculing any underlying malignancies before establishing a diagnosis of skeletal sarcoidosis when bone lesions are observed at unusual sites.
结节病主要累及肺部、胸内淋巴结和眼睛;较少累及肌肉骨骼系统。我们在此报告一例患有多发性骨髓瘤的患者发生副肿瘤性结节病。该患者出现眼部结节病,并且在纵隔淋巴结和脊柱显示出氟脱氧葡萄糖摄取增加。淋巴结标本显示出结节病的组织学特征,而对脊柱肿瘤的检查发现是骨髓瘤。虽然结节病和骨髓瘤同时发生极为罕见,但我们的病例表明,当在不寻常部位观察到骨病变时,在诊断骨骼结节病之前排除任何潜在恶性肿瘤的重要性。