Liu Sha, Tong Chengbi, Xie Junmin, Zang Shasha
Department of Cardiology, Affiliated Hospital of Hebei University Baoding 071000, Hebei, China.
Department of Laboratory, Affiliated Hospital of Hebei University Baoding 071000, Hebei, China.
Am J Transl Res. 2025 Jul 15;17(7):5195-5201. doi: 10.62347/YWDH3068. eCollection 2025.
Initial diagnosis: A 60-year-old male presented with initial diagnosis chest tightness, fatigue, and arrhythmia. Indications for plasma cell tumour: Initial imaging suggested amyloidosis due to myocardial thickening. Left ventricular hypertrophy and delayed enhancement on Magnetic Resonance Imaging (MRI), along with an elevated κ:λ ratio, raising suspicion for a plasma cell tumour. Confirmation of the plasma tumour: Further diagnostic tests, including immunofixation electrophoresis and myocardial biopsy, confirmed a plasma cell tumour. The patient was diagnosed with light chain (AL) amyloidosis, a subtype of plasma cell tumor, confirmed by bone marrow biopsy and immunohistochemistry. Treatment: Treatment with bortezomib, dexamethasone, and daratumumab resulted in significant symptomatic improvement. Conclusion: This case underscores the importance of considering plasma cell disorders in unexplained cardiac hypertrophy and highlights the need for early diagnostic strategies and targeted therapies.
一名60岁男性最初表现为胸闷、疲劳和心律失常。浆细胞瘤的指征:初始影像学检查提示因心肌增厚导致淀粉样变性。磁共振成像(MRI)显示左心室肥厚及延迟强化,同时κ:λ比值升高,引发了对浆细胞瘤的怀疑。浆细胞瘤的确诊:进一步的诊断测试,包括免疫固定电泳和心肌活检,确诊为浆细胞瘤。患者被诊断为轻链(AL)淀粉样变性,这是浆细胞瘤的一种亚型,通过骨髓活检和免疫组织化学得以证实。治疗:使用硼替佐米、地塞米松和达雷妥尤单抗治疗后,症状得到显著改善。结论:该病例强调了在不明原因的心脏肥大中考虑浆细胞疾病的重要性,并突出了早期诊断策略和靶向治疗的必要性。