Pudill R, Bettges G, Metz K
Immun Infekt. 1982 May;10(3):115-7.
An epipharyngeal solitary extramedullary plasmacytoma with subsequent dedifferentiation is described. Immunohistochemically the plasmacytoma cells of the first biopsy were positive for lambda and gamma, immunoelectrophoretically only lambda was demonstrable. Three months later an anaplastic tumor reappeared whose cells were also immunohistochemically positive for lambda and gamma. However, paraproteins were no longer demonstrable in serum and urine. The observed changes were interpreted as a result of anaplasia. Furthermore, our case shows that the diagnosis of multiple myeloma is not always possible by means of immunoelectrophoresis. The most important implication of our case is the fact that a follow-up of serum or urine concentrations of paraproteins may not reflect the course of a given plasmacytoma.
本文描述了一例伴有后续去分化的咽上孤立性髓外浆细胞瘤。首次活检的浆细胞瘤细胞免疫组化显示λ和γ阳性，免疫电泳仅可检测到λ。三个月后，一个间变性肿瘤复发，其细胞免疫组化也显示λ和γ阳性。然而，血清和尿液中不再能检测到副蛋白。观察到的变化被解释为间变的结果。此外，我们的病例表明，通过免疫电泳并不总是能够诊断多发性骨髓瘤。我们病例最重要的意义在于，血清或尿液中副蛋白浓度的随访可能无法反映特定浆细胞瘤的病程。
