Erciyestepe Mert, Tiryaki Tarık Onur, Yönal Hindilerden İpek, Yeğen Gülçin, Nalçacı Meliha
Istanbul University, Istanbul Medical Faculty, Department of Internal Medicine, Istanbul, Turkey.
Istanbul University, Istanbul Medical Faculty, Department of Internal Medicine, Division of Hematology, Istanbul, Turkey.
Case Rep Hematol. 2020 Jul 17;2020:5738319. doi: 10.1155/2020/5738319. eCollection 2020.
Multiple myeloma is a type of plasma cell disorder and can be seen in different forms. According to current knowledge, it is not a curable disease. Smoldering multiple myeloma (SMM) is an asymptomatic clonal plasma cell disorder and distinguished from monoclonal gammopathy of undetermined significance by a much higher risk of progression to multiple myeloma. We present a 53-year-old female patient who started with SMM which turned into multiple myeloma after four years. Despite 26 cycles of lenalidomide treatment, we performed the second autologous stem transplantation. After 12 years from the diagnosis of the disease, it was transformed into plasma cell leukemia and widespread nodular lesions were seen in the liver. Different presentations could be seen due to malignant plasma cell infiltrations or primary amyloidosis. Liver involvement is one of them and is less common than other organ involvement. We report a case of myeloma presenting with extensive nodular involvement in the liver and misdiagnosed as metastatic disease. It is important because of its rarity and change of the treatment approach.
多发性骨髓瘤是一种浆细胞疾病，有多种不同形式。根据目前的认知，它是一种不可治愈的疾病。冒烟型多发性骨髓瘤（SMM）是一种无症状的克隆性浆细胞疾病，与意义未明的单克隆丙种球蛋白病的区别在于进展为多发性骨髓瘤的风险要高得多。我们报告一名53岁女性患者，她最初诊断为SMM，四年后转变为多发性骨髓瘤。尽管接受了26个周期的来那度胺治疗，我们还是进行了第二次自体造血干细胞移植。在疾病诊断12年后，它转变为浆细胞白血病，肝脏出现广泛的结节性病变。由于恶性浆细胞浸润或原发性淀粉样变性，可能会出现不同的表现。肝脏受累就是其中之一，且比其他器官受累少见。我们报告一例骨髓瘤患者，其肝脏出现广泛的结节性受累，最初被误诊为转移性疾病。因其罕见性及治疗方法的改变，该病例具有重要意义。
