Pantelidou Maria, Dimitriou Eleni, Gkontopoulos Konstantinos, Thomopoulos Thomas, Pappa Vasiliki, Papageorgiou Sotirios G, Theodossiadis Panagiotis, Chatziralli Irini
2nd Department of Ophthalmology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
2nd Department of Propaedeutic Internal Medicine, Hematology Unit, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
J Hematol. 2024 Aug;13(4):164-167. doi: 10.14740/jh1267. Epub 2024 Aug 15.
Multiple myeloma is a plasma cell dyscrasia with an age-standardized incidence of 3 - 4 per 100,000 in the Caucasian population. It is the second most common hematological malignancy after non-Hodgkin lymphoma, representing 1% of all cancers. Herein, we present a case report of multiple myeloma with ocular involvement as a sign of recurrence. A 62-year-old woman, with a known history of lambda light chain multiple myeloma, presented with reduced visual acuity in both eyes while on maintenance chemotherapy. The patient also had mild unsteadiness and fatigue. Fundus examination revealed bilateral optic disc swelling and hemorrhages of the posterior pole. Magnetic resonance imaging disclosed no abnormalities. Although no biopsy of the optic nerve was possible, intracranial pressure was elevated and cerebrospinal fluid was riddled with neoplastic cells, affirming the diagnosis. After 2 months of chemotherapy, visual function and the appearance of the posterior pole returned to normal. In cases of multiple myeloma, mechanisms, such as hyperviscosity syndrome, microvascular impairment and optic nerve and meningeal infiltration on a cellular level may have played a pivotal role in the ocular involvement, which can be the first sign of recurrence.
多发性骨髓瘤是一种浆细胞发育异常疾病，在白种人群中的年龄标准化发病率为每10万人中有3 - 4例。它是仅次于非霍奇金淋巴瘤的第二常见血液系统恶性肿瘤，占所有癌症的1%。在此，我们报告一例以眼部受累为复发征象的多发性骨髓瘤病例。一名62岁女性，已知患有λ轻链多发性骨髓瘤，在维持化疗期间出现双眼视力下降。患者还伴有轻度步态不稳和疲劳。眼底检查发现双侧视盘肿胀及后极部出血。磁共振成像未发现异常。尽管无法对视神经进行活检，但颅内压升高且脑脊液中充满肿瘤细胞，从而确诊。化疗2个月后，视功能及后极部外观恢复正常。在多发性骨髓瘤病例中，诸如高黏滞综合征、微血管损伤以及细胞水平的视神经和脑膜浸润等机制可能在眼部受累中起关键作用，而眼部受累可能是复发的首发征象。
