Gordon V, Bezwoda W, Derman D, Kramer S, Mendelow B
Am J Hematol. 1986 Oct;23(2):81-7. doi: 10.1002/ajh.2830230202.
Twenty-one patients with serum monoclonal gammopathy but lacking acceptable morphological evidence of myelomatosis were studied with reference to the degree, if any, of monoclonal plasma cell expansion in aspirated marrow samples, enriched for plasma cells and analysed with respect to light chain distribution. Four of these patients had a biopsy-proven plasmacytoma of bone. Bone marrow aspirated from sites distant to the tumor showed clear evidence of infiltration by monoclonal plasma cells in two of the cases studied; the other two patients had normal results. Of the 17 other cases, 14 showed evidence of a monoclonal plasma cell component qualitatively concordant with the serum paraprotein as one would expect. These cases could be subdivided into those with myeloma (six cases) and those with monoclonal gammopathy of undetermined significance (eight cases) on the basis of conventional biochemical and radiological criteria. Three of the 17 patients, however, did not show evidence of monoclonal plasma cell infiltration, despite the presence of lytic lesions. It is important to recognize this minority group that simulates myeloma but that may well reflect alternative pathology that has not been identified.
对21例血清单克隆丙种球蛋白病患者进行了研究，这些患者缺乏骨髓瘤病可接受的形态学证据，研究内容涉及抽取的骨髓样本中（经富集浆细胞处理并根据轻链分布进行分析）单克隆浆细胞扩增的程度（若存在的话）。其中4例患者经活检证实患有骨浆细胞瘤。在研究的2例病例中，从肿瘤远处部位抽取的骨髓显示有单克隆浆细胞浸润的明确证据；另外2例患者结果正常。在其他17例病例中，如图所料，14例显示出与血清副蛋白在质量上吻合致的单克隆浆细胞成分证据。根据传统的生化和放射学标准，这些病例可细分为骨髓瘤病例（6例）和意义未明的单克隆丙种球蛋白病病例（8例）。然而，17例患者中有3例尽管存在溶骨性病变，但未显示单克隆浆细胞浸润的证据。认识到这一模拟骨髓瘤但很可能反映尚未明确的其他病理情况的少数群体很重要。
