Sato Y, Mizoguchi K, Ohta Y
No To Shinkei. 1986 Apr;38(4):399-403.
Cerebrospinal fluid (CSF) involvement in myeloma is rarely seen. Recently we experienced a case with this lesion. A 70-year-old man developed consciousness level disorder during the course of bronchopneumonia. Neurological examination revealed stuporous consciousness, neck stiffness and Kernig's sign. Immunoelectrophoresis showed monoclonal IgG in serum. CSF which was obtained through lumbar puncture was clear and its pressure was 155 mm H2O. It contained 207 white cells/3 mm3; glucose, 54 mg/dl; and protein, 33 mg/dl. The differential count of the CSF was (in %) monocytes, 48.0; plasma cells, 25.5; neutrocytes, 15.5; and lymphocytes, 11.0. Cytoplasm and nucleus of the plasma cells were in various sizes. Some irregular multiple nuclei, flaming cells and grape cells were also observed in them. The cytoplasm of the plasma cells fluoresced with antisera against lambda chains IgG. The value of immunofluorescent technique in identifying plasma cells in the CSF is emphasized.
脑脊液（CSF）受累于骨髓瘤的情况很少见。最近我们遇到了一例有此病变的病例。一名70岁男性在支气管肺炎病程中出现意识水平障碍。神经系统检查显示意识昏迷、颈部强直及克氏征阳性。免疫电泳显示血清中有单克隆IgG。通过腰椎穿刺获取的脑脊液清澈，压力为155mmH₂O。每3mm³含207个白细胞；葡萄糖54mg/dl；蛋白质33mg/dl。脑脊液的分类计数（百分比）为：单核细胞48.0；浆细胞25.5；中性粒细胞15.5；淋巴细胞11.0。浆细胞的细胞质和细胞核大小各异。其中还观察到一些不规则的多核细胞、火焰状细胞和葡萄状细胞。浆细胞的细胞质用抗λ链IgG抗血清呈荧光反应。强调了免疫荧光技术在识别脑脊液中浆细胞方面的价值。
