Khade Parth, Devarakonda Srinivas
Department of Internal Medicine, Louisiana State University Health, Shreveport, LA, USA.
Int Med Case Rep J. 2017 Nov 8;10:373-376. doi: 10.2147/IMCRJ.S147266. eCollection 2017.
Multiple myeloma is a plasma cell dyscrasia characterized by neoplastic proliferation of plasma cells, producing a monoclonal immunoglobulin. Small lymphocytic lymphoma (SLL) is a neoplasm consisting of monoclonal B-cell lymphocyte proliferation. We present an extremely rare case of coexisting multiple myeloma, SLL, and squamous cell carcinoma of the lung in a 74-year-old female patient. She initially presented with a midline mass with pain in the lumbar area. Debulking surgery was performed, and pathology showed plasmacytoma. Further evaluation revealed coexistent IgG kappa myeloma. Imaging revealed extensive abdominal lymphadenopathy, and mesenteric lymph node biopsy confirmed the presence of SLL. The patient was also found to have a mass in the left lower lobe of the lung; biopsy showed squamous cell carcinoma. This patient was treated with lenalidomide and dexamethasone for multiple myeloma, and stereotactic body radiotherapy for limited stage lung cancer. Due to the more indolent course of SLL, watchful waiting was applied.
多发性骨髓瘤是一种浆细胞发育异常，其特征为浆细胞的肿瘤性增殖，产生单克隆免疫球蛋白。小淋巴细胞淋巴瘤（SLL）是一种由单克隆B细胞淋巴细胞增殖构成的肿瘤。我们报告了一例极为罕见的病例，一名74岁女性患者同时患有多发性骨髓瘤、SLL和肺鳞状细胞癌。她最初表现为中线肿块伴腰部疼痛。进行了减瘤手术，病理显示为浆细胞瘤。进一步评估发现并存IgG κ型骨髓瘤。影像学检查显示广泛的腹部淋巴结肿大，肠系膜淋巴结活检证实存在SLL。该患者还被发现左肺下叶有一个肿块；活检显示为鳞状细胞癌。该患者接受了来那度胺和地塞米松治疗多发性骨髓瘤，以及立体定向体部放疗治疗局限性肺癌。由于SLL病程较为惰性，采取了观察等待的策略。
