Patolia Setu, Schmidt Frances, Patolia Swati, Gulati Neerja, Muhammad Perwaiz, Narendra Dharani, Enriquez Danilo, Quist Joseph
Interfaith Medical Center, Brooklyn, NY, USA.
World J Oncol. 2012 Apr;3(2):78-82. doi: 10.4021/wjon440w. Epub 2012 Apr 23.
Multiple myeloma - a neoplastic proliferation of plasma cell is the second most common blood cancer. Multiple myeloma is characterized by neoplastic proliferation of the plasma cells. These cells infiltrate variety of organs. Infiltration by immature neoplastic cells and overproduction of monoclonal immunoglobulin chain is responsible for clinical manifestations of multiple myeloma. The most common clinical presentation of multiple myeloma is an asymptomatic person having anemia and elevated globulin in laboratory testing. Multiple myeloma is diagnosed by triad of > 10% marrow infiltration by plasma cells, serum/urine monoclonal protein and end organ damages. One of the common end organ damage is lytic bone lesions resulting from imbalance between osteolytic and osteoblastic activities. Lymphadenopathy and osteoblastic lesions are rare presentations of multiple myeloma - lymphadenopathy in 1% of cases with IgA subtype and osteoblastic lesions in IgE myeloma and lambda light chains. Osteoblastic multiple myeloma is a distinct entity from POEMS syndrome. IgG myeloma with kappa chain predominance is not described yet with osteoblastic lesions and lymphadenopathy. We present a rare case of IgG myeloma with kappa chain predominance that had both lymphadenopathy and osteoblastic lesions.
多发性骨髓瘤——一种浆细胞的肿瘤性增殖，是第二常见的血液癌症。多发性骨髓瘤的特征是浆细胞的肿瘤性增殖。这些细胞浸润多种器官。未成熟肿瘤细胞的浸润和单克隆免疫球蛋白链的过度产生是多发性骨髓瘤临床表现的原因。多发性骨髓瘤最常见的临床表现是在实验室检查中无症状但有贫血和球蛋白升高的人。多发性骨髓瘤通过浆细胞骨髓浸润>10%、血清/尿单克隆蛋白和终末器官损害这三联征来诊断。常见的终末器官损害之一是溶骨性骨病变，这是由溶骨和成骨活动失衡导致的。淋巴结病和成骨性病变是多发性骨髓瘤的罕见表现——IgA亚型病例中1%出现淋巴结病，IgE骨髓瘤和λ轻链病例中出现成骨性病变。成骨性多发性骨髓瘤与POEMS综合征是不同的实体。κ链为主的IgG骨髓瘤尚未有关于成骨性病变和淋巴结病的描述。我们报告一例罕见的κ链为主的IgG骨髓瘤，其同时伴有淋巴结病和成骨性病变。
