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多发性骨髓瘤背景下淀粉样瘤引起的胃黏膜下血肿。

Gastric submucosal haematoma caused by an amyloidoma in the setting of multiple myeloma.

作者信息

Pak Stella C, Markovic John-Phillip T

机构信息

Department of Medicine, Kettering Medical Center, Kettering, OH 45429, USA.

Department of Medicine, Kettering Medical Center, Kettering, OH 45429, USA.

出版信息

Arab J Gastroenterol. 2017 Dec;18(4):238-240. doi: 10.1016/j.ajg.2017.12.002. Epub 2017 Dec 15.

Abstract

This is a case of a 67-year-old woman with a history of multiple myeloma with amyloidosis who presented with massive hematemesis. Emergent upper endoscopy revealed a mass on the greater curvature of the stomach, which measured approximately 3 cm in width and 7 cm in length. The patient underwent a wedge resection of the gastric mass without complication. Microscopic examination of the gastric mass revealed amorphous deposits that were congophilic in nature and stained positive with Alcian blue. These findings are consistent with amyloidosis. The patient had a favourable postoperative recovery and was discharged from the hospital. This case highlights the need for clinicians to be aware of the possibility of spontaneous gastric haemorrhage secondary to light chain (AL) amyloidosis, especially in patients with a known bone marrow disorder.

摘要

这是一例67岁女性患者,有多发性骨髓瘤合并淀粉样变性病史,现出现大量呕血。急诊上消化道内镜检查发现胃大弯处有一肿物,宽约3厘米,长约7厘米。患者接受了胃肿物楔形切除术,无并发症。对胃肿物进行显微镜检查发现有非晶形沉积物,本质上为刚果红嗜染,阿尔辛蓝染色呈阳性。这些发现符合淀粉样变性。患者术后恢复良好,已出院。该病例强调临床医生需要意识到轻链(AL)淀粉样变性继发自发性胃出血的可能性,尤其是在已知有骨髓疾病的患者中。

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