多发性骨髓瘤 CD138 由阳性转为阴性：一例报告。
Multiple myeloma with CD138 changed from positive to negative: A case report.
机构信息
Jiangxi Province Key Laboratory of Laboratory Medicine, Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
出版信息
Cytometry B Clin Cytom. 2021 Mar;100(2):249-253. doi: 10.1002/cyto.b.21869. Epub 2020 Jan 22.
BACKGROUND
Multiple myeloma (MM) is a common malignant disease of the blood system, caused by the neoplastic proliferation of plasma cells that accumulate in bone marrow (BM). Here, we report a case of MM patient with CD138 marker changed from positive to negative.
METHODS
BM and peripheral blood samples from a 48-year-old patient with MM were examined and analyzed by conventional morphology, flow cytometry, and immunodetection.
RESULTS
Imaging examination and clinical manifestations fulfilled criteria for MM. On the first hospitalization, flow cytometry showed that the cells were CD138 /CD38 /CD19 /CD56 . However, on the fifth hospitalization, flow cytometry revealed that the cells were CD138 /CD38 /CD19 /CD56 .
CONCLUSIONS
MM is diagnosed on imaging and clinical manifestations, immunophenotype of flow cytometry is also an important method of diagnosing MM. However, the discovery of atypical immunophenotypes cannot prevent the diagnosis of MM, even provide a clue of disease progression.
背景
多发性骨髓瘤（MM）是一种常见的血液系统恶性疾病，由浆细胞的恶性增殖引起，这些浆细胞在骨髓（BM）中积聚。在这里，我们报告了一例 CD138 标志物由阳性变为阴性的 MM 患者。
方法
对一名 48 岁 MM 患者的 BM 和外周血样本进行了常规形态学、流式细胞术和免疫检测分析。
结果
影像学检查和临床表现符合 MM 标准。第一次住院时，流式细胞术显示细胞为 CD138/CD38/CD19/CD56。然而，第五次住院时，流式细胞术显示细胞为 CD138/CD38/CD19/CD56。
结论
MM 的诊断基于影像学和临床表现，流式细胞术的免疫表型也是诊断 MM 的重要方法。然而，不典型免疫表型的发现不能排除 MM 的诊断，甚至可以为疾病进展提供线索。
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