Quach Priscilla, Lack Michael, Ash Ryan M, Cunningham Mark T, Farrell Daniel
Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, USA.
Radiology, University of Kansas Medical Center, Kansas City, USA.
Cureus. 2024 Dec 8;16(12):e75336. doi: 10.7759/cureus.75336. eCollection 2024 Dec.
This report describes a rare case of relapsed multiple myeloma in the gastrointestinal tract with aberrant CD3 expression. Upon admission for acute renal failure, the patient had abnormal computed tomography scan findings of the abdomen and pelvis. Subsequent colonoscopy found numerous polyps and masses. Histologic examination of a biopsy of one of the masses revealed a diffuse atypical cellular infiltrate with undifferentiated morphology in the submucosa that was positive for CD3, CD4, weak and variable CD79a, CD138, BCL2, CMYC, MUM1, vimentin, and monoclonal cytoplasmic lambda. A diagnosis of recurrent plasma cell myeloma was made. The positive expression of T-cell markers CD3 and CD4 may cause confusion with T-cell lymphoma in a scenario with undifferentiated morphology as in our case.
本报告描述了一例罕见的胃肠道复发性多发性骨髓瘤伴异常CD3表达的病例。因急性肾衰竭入院时，患者腹部和骨盆的计算机断层扫描结果异常。随后的结肠镜检查发现大量息肉和肿块。对其中一个肿块进行活检的组织学检查显示，黏膜下层有弥漫性非典型细胞浸润，形态未分化，CD3、CD4、弱阳性且可变的CD79a、CD138、BCL2、CMYC、MUM1、波形蛋白和单克隆细胞质λ均呈阳性。诊断为复发性浆细胞骨髓瘤。在像我们病例中这种形态未分化的情况下，T细胞标志物CD3和CD4的阳性表达可能会与T细胞淋巴瘤混淆。
