Harrop Gemma Ann Joan, Tighe Jane, MacKenzie Alexander
Infectious diseases, NHS Grampian, Aberdeen, UK.
BMJ Case Rep. 2018 Jan 23;2018:bcr-2017-222035. doi: 10.1136/bcr-2017-222035.
A 68-year-old man presented with a 4-day history of worsening knee and arm pain. On examination, there was erythema and swelling of the left knee and both wrists. Joint aspiration grew Blood tests showed an unusually high total protein level (100 g/L) and an IgM kappa paraprotein band of 45 g/L on protein electrophoresis. CT showed widespread lymphadenopathy, hepatosplenomegaly and multilevel thoracic vertebral collapse. A bone marrow biopsy revealed a lymphoplasmacytic infiltrate and a lymph node biopsy showed features of nodal marginal zone lymphoma with plasmacytic differentiation.
一名68岁男性，因膝关节和手臂疼痛加重4天前来就诊。检查发现左膝和双腕有红斑和肿胀。关节穿刺抽出物培养出……血液检查显示总蛋白水平异常高（100g/L），蛋白电泳显示IgM κ型副蛋白带为45g/L。CT显示广泛的淋巴结肿大、肝脾肿大以及多个胸椎椎体塌陷。骨髓活检显示淋巴细胞和浆细胞浸润，淋巴结活检显示具有浆细胞分化的边缘区淋巴瘤特征。
