Jum'ah Husam, Wang Yan, Ayub Salman
MetroHealth Medical Center, Department of Pathology, Cleveland, Ohio, USA.
Autops Case Rep. 2022 Jul 21;12:e2021393. doi: 10.4322/acr.2021.393. eCollection 2022.
Co-occurrence of myelodysplastic syndrome (MDS) and plasma cell neoplasm in patients with no history of chemo and/or radiotherapy is rarely reported. Herein, we report a case of a female in her seventieth decade of life who was referred to the hospital for pancytopenia. The patient was asymptomatic and was doing well overall. Serum protein electrophoresis was remarkable for a lambda-restricted monoclonal protein (IgG) estimated at 1.8g/dL. Immunoglobulin G serum level was also elevated, and serum Kappa/Lambda free light chain ratio was decreased. At that time, a bone marrow biopsy showed myelodysplastic syndrome with excess blasts-2 (MDS-EB2) and a monoclonal plasma cell proliferation. Some studies have shown that patients with plasma cell neoplasm could be associated with an increased risk of developing MDS compared to the general population. Based on reviewing the literature, to our knowledge, the pathological mechanism of the co-occurrence of both diseases is not yet clear.
化疗和/或放疗史阴性的患者中，骨髓增生异常综合征（MDS）与浆细胞肿瘤同时出现的情况鲜有报道。在此，我们报告一例70多岁的女性患者，因全血细胞减少症入院。该患者无症状，总体情况良好。血清蛋白电泳显示λ限制型单克隆蛋白（IgG）显著，估计为1.8g/dL。免疫球蛋白G血清水平也升高，血清κ/λ游离轻链比值降低。当时，骨髓活检显示伴有过多原始细胞的骨髓增生异常综合征-2（MDS-EB2）和单克隆浆细胞增殖。一些研究表明，与普通人群相比，浆细胞肿瘤患者发生MDS的风险可能增加。据我们所知，基于文献回顾，两种疾病同时出现的病理机制尚不清楚。
