Shi Xiaofeng, Wu Jiannong, Jiang Qian, Zhang Shuo, Chen Wanru, Yu Xianqiu, Liu Yichen, Chen Min, Peng Jie, Li Tiantian, Zhu Yan, Xi Xiaodong
Affiliated Hospital of Jiangsu University, No. 438, North Jiefang Road, Zhenjiang, Jiangsu, PR.
The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu.
Medicine (Baltimore). 2020 Oct 30;99(44):e22931. doi: 10.1097/MD.0000000000022931.
Synchronous development of both anaplastic large cell lymphoma (ALCL) and multiple myeloma (MM) in a patient is rare. To our knowledge, until now only one case has been reported. Treatment needs to cover both and is a challenge. Here we reported another case and discussed the diagnosis and treatment.
This is a 63-year old woman who presented with a mass in upper abdominal skin. Positron emission tomography/computed tomography (PET/CT) showed the high metabolism in left abdominal skin and left axillary lymph nodes. Histopathologic and immunohistochemical evaluation identified the cutaneous mass as an ALK-negative ALCL. Bone marrow smear showed increased plasma cells which expressed CD38, CD138, and cLambda concomitantly. The increased monoclonal immunoglobulin IgD λ was detected by immunofixation electrophoresis.
Diagnosis of both ALCL and MM was confirmed.
The patient successively received 6 cycles of B-CHOD regimen, one cycle of ID regimen, 2 cycles of DHAX regimen, one cycle of L-DA-EPOCH and autologous stem cell transplantation (ASCT). Then lenalidomide was performed as a maintenance therapy.
Both ALCL and MM achieved complete remission.
We reported a very rare case with synchronous development of ALCL and MM, in whom a good therapeutic response to chemotherapies followed by ASCT has been observed.
患者同时发生间变性大细胞淋巴瘤（ALCL）和多发性骨髓瘤（MM）的情况较为罕见。据我们所知，迄今为止仅报道过一例。治疗需要兼顾两者，这是一项挑战。在此，我们报告另一例病例并讨论其诊断与治疗。
这是一名63岁女性，上腹部皮肤出现肿物。正电子发射断层扫描/计算机断层扫描（PET/CT）显示左腹部皮肤和左腋窝淋巴结代谢增高。组织病理学和免疫组化评估确定皮肤肿物为ALK阴性的ALCL。骨髓涂片显示浆细胞增多，同时表达CD38、CD138和cLambda。免疫固定电泳检测到单克隆免疫球蛋白IgDλ升高。
确诊为ALCL和MM。
患者先后接受了6个周期的B-CHOD方案、1个周期的ID方案、2个周期的DHAX方案、1个周期的L-DA-EPOCH方案以及自体干细胞移植（ASCT）。随后进行来那度胺维持治疗。
ALCL和MM均实现完全缓解。
我们报告了一例极为罕见的ALCL和MM同时发生的病例，观察到该患者对化疗及后续ASCT有良好的治疗反应。
