Yamaguchi Ritsuki, Shimizu Yousuke, Nakayasu Ryota, Utsunomiya Noriaki, Ishihara Misa, Hashimoto Kimio, Kanamaru Sojun
The Department of Urology, Kobe City Nishi-Kobe Medical Center.
The Department of Pathology, Kobe City Nishi-Kobe Medical Center.
Hinyokika Kiyo. 2022 May;68(5):149-153. doi: 10.14989/ActaUrolJap_68_5_149.
A 78-year-old man was treated with Bortezomib, Lenalidomide, and Dexamethasone, for multiple myeloma. Two years after the start of treatment, the patient came to our department with a complaint of gross hematuria. Cystoscopy revealed a tumor on the left wall of the bladder. Urine cytology was negative. Magnetic resonance imaging (MRI) of the lower abdomen showed a slightly high signal on the T2-weighted image, indicating an intravesical mass lesion invading outside the bladder. Contrast-enhanced computed tomography (CT) also showed an intravesical mass and enlarged left external iliac lymph node swelling. Transurethral resection of bladder tumor was performed. The resection specimen showed tumor cells. The pathological examination revealed CD138 (+) and light-chain restriction. The patient was diagnosed with plasmacytoma. The patient was treated with radiation therapy for plasmacytoma of the bladder and surrounding lymph nodes, and then with daratumumab and dexamethasone for multiple myeloma for one year; however, the patient died because of worsening of multiple myeloma.
一名78岁男性因多发性骨髓瘤接受硼替佐米、来那度胺和地塞米松治疗。治疗开始两年后,患者因肉眼血尿前来我科就诊。膀胱镜检查发现膀胱左壁有一个肿瘤。尿液细胞学检查为阴性。下腹部磁共振成像(MRI)在T2加权图像上显示略高信号,提示膀胱内肿块病变侵犯膀胱外。增强计算机断层扫描(CT)也显示膀胱内肿块以及左侧髂外淋巴结肿大。进行了经尿道膀胱肿瘤切除术。切除标本显示有肿瘤细胞。病理检查显示CD138(+)且有轻链限制。该患者被诊断为浆细胞瘤。患者接受了膀胱及周围淋巴结浆细胞瘤的放射治疗,随后接受达雷妥尤单抗和地塞米松治疗多发性骨髓瘤一年;然而,患者因多发性骨髓瘤病情恶化而死亡。