Vakulenko N N, Sonina E I
Zh Nevropatol Psikhiatr Im S S Korsakova. 1986;86(7):1047-51.
Histopathologic changes in the brain and spinal cord in multiple myeloma are similar to those seen in toxic encephalopathy with circulatory disorders. Irreversible morphologic changes in the brain and spinal cord are more pronounced in the encephalopathic syndrome. The structures affected most are the cerebral cortex, brain pedicles, medulla oblongata, spinal cord and its radicles. Histopathologic changes include acute nerve cell swelling, primary irritation, cytoplasmic fatty infiltration, shrinkage, excessive lipofucsin deposition, demyelination and diminished numbers of nerve fibers, and predominantly dystrophic, rather than hyperplastic, changes in the glia.
多发性骨髓瘤患者脑和脊髓的组织病理学变化与伴有循环系统障碍的中毒性脑病所见相似。脑和脊髓不可逆的形态学变化在脑病综合征中更为明显。受影响最严重的结构是大脑皮质、脑桥、延髓、脊髓及其神经根。组织病理学变化包括急性神经细胞肿胀、原发性刺激、细胞质脂肪浸润、萎缩、脂褐素过度沉积、脱髓鞘和神经纤维数量减少,以及神经胶质细胞主要为营养不良性而非增生性变化。