Gomez E C, Margulies M, Rywlin A, Cabello B, Dominguez C
Arch Dermatol. 1978 Nov;114(11):1700-3.
Multiple, firm, nontender, violaceous, cutaneous and subcutaneous nodules of the abdomen and thighs developed in a 53-year-old man with proven IgD myeloma. A biopsy specimen showed dermal infiltration by large atypical undifferentiated cells similar to those previously found on bone marrow aspiration. Despite intermittent improvement with radiotherapy and chemotherapy, the patient died and an autopsy showed multiple osteolytic lesions and massive involvement with tumors that encased the pelvic organs, infiltrated and replaced portions of the psoas muscles, infiltrated the kidneys and intestines, and replaced the bone marrow by small and intermediate-sized malignant lymphoid cells. IgD myeloma is a rare hematologic malignancy that occurs at a younger age than other forms of myeloma, has a high incidence of involvement of soft tissues, and is a particularly dedifferentiated and vicious form of myeloma.
一名53岁确诊为IgD骨髓瘤的男性患者腹部和大腿出现多个坚实、无压痛、紫红色的皮肤和皮下结节。活检标本显示真皮被大的非典型未分化细胞浸润，这些细胞与先前骨髓穿刺中发现的细胞相似。尽管放疗和化疗后有间歇性改善，但患者仍死亡，尸检显示有多个溶骨性病变，肿瘤广泛累及，包绕盆腔器官，浸润并取代部分腰大肌，浸润肾脏和肠道，骨髓被小和中等大小的恶性淋巴细胞取代。IgD骨髓瘤是一种罕见的血液系统恶性肿瘤，发病年龄比其他类型的骨髓瘤小，软组织受累发生率高，是一种特别去分化且恶性的骨髓瘤形式。
