Rossi J F, Bataille R, Chappard D, Alexandre C, Janbon C
Am J Med. 1987 Jul;83(1):10-6. doi: 10.1016/0002-9343(87)90491-8.
Nine unusual cases of B cell malignancies presenting with lytic bone lesions on radiography and/or hypercalcemia, and mimicking multiple myeloma are reported in this study. These cases included acute lymphoblastic leukemia (one patient), non-Hodgkin's lymphoma (five patients), chronic lymphocytic leukemia (two patients), and Waldenström's disease (one patient). Quantitative bone biopsy performed in two patients (one with non-Hodgkin's lymphoma and one with Waldenström's disease) demonstrated a dramatic increase in osteoclastic resorption close to tumor cells in both cases, similar to or even more marked than that observed in multiple myeloma. Finally, significant production of bone resorbing activity was found in short-term liquid culture specimens of tumor cells in eight of the nine cases. These observations clearly indicate that in B cell disorders other than multiple myeloma, the malignant B cells can produce significant bone resorbing activity in vitro and result in excessive osteoclastic resorption and lytic bone lesions, frequent hypercalcemia, and an overall disease picture clinically mimicking multiple myeloma.
本研究报告了9例不寻常的B细胞恶性肿瘤病例，这些病例在X线片上表现为溶骨性骨病变和/或高钙血症，且酷似多发性骨髓瘤。这些病例包括急性淋巴细胞白血病（1例患者）、非霍奇金淋巴瘤（5例患者）、慢性淋巴细胞白血病（2例患者）和华氏巨球蛋白血症（1例患者）。对2例患者（1例非霍奇金淋巴瘤患者和1例华氏巨球蛋白血症患者）进行的定量骨活检显示，两例患者肿瘤细胞附近的破骨细胞吸收均显著增加，与多发性骨髓瘤中观察到的情况相似，甚至更为明显。最后，在9例中的8例肿瘤细胞短期液体培养标本中发现了显著的骨吸收活性。这些观察结果清楚地表明，在多发性骨髓瘤以外的B细胞疾病中，恶性B细胞在体外可产生显著的骨吸收活性，并导致破骨细胞过度吸收和溶骨性骨病变、频繁的高钙血症，以及临床上酷似多发性骨髓瘤的整体疾病表现。
