Knowles D M, Halper J A, Trokel S, Jakobiec A
Am J Ophthalmol. 1978 Apr;85(4):485-94. doi: 10.1016/s0002-9394(14)75246-8.
A biopsy specimen from a 59-year-old man with unilateral proptosis revealed an orbital plasmacytic tumor. In vitro immunoperoxidase and immunofluorescence studies and direct immunoperoxidase staining of Bouin's fixed, paraffin-embedded tissue sections demonstrated that the tumor consisted of plasma cells with surface and intracellular IgDlambda immunoglobulin. Systemic evaluation demonstrated multiple myeloma. A review of previously published reports combined with the case presented here suggests that IgD myeloma has a predilection for orbital involvement. Thus, while IgD myeloma accounts for only 2% of all myelomas, it may account for a significant percentage of myelomas with orbital involvement. The distinctive clinical course of IgD myeloma, particularly its poor prognosis, warrants consideration of the immunologic and serologic findings in patients with orbital involvement by myeloma. The application of immunofluorescence and immunoperoxidase techniques to the study of orbital lymphoreticular neoplasms should result in a clearer understanding of these neoplasms.
一名59岁单侧眼球突出男性的活检标本显示为眼眶浆细胞瘤。体外免疫过氧化物酶和免疫荧光研究以及对经Bouin固定、石蜡包埋的组织切片进行直接免疫过氧化物酶染色表明，肿瘤由具有表面和细胞内IgDλ免疫球蛋白的浆细胞组成。全身评估显示为多发性骨髓瘤。对先前发表的报告进行回顾并结合此处呈现的病例表明，IgD骨髓瘤易累及眼眶。因此，虽然IgD骨髓瘤仅占所有骨髓瘤的2%，但它可能在累及眼眶的骨髓瘤中占相当大的比例。IgD骨髓瘤独特的临床病程，尤其是其预后不良，使得在骨髓瘤累及眼眶的患者中考虑免疫和血清学检查结果很有必要。将免疫荧光和免疫过氧化物酶技术应用于眼眶淋巴网状肿瘤的研究应能更清楚地了解这些肿瘤。
