Matsumoto A, Nagata K, Hamaguchi H, Taki K
Department of Internal Medicine, Musashino Red Cross Hospital, Tokyo, Japan.
Int J Hematol. 1993 Dec;59(1):59-65.
A rare case of IgG-kappa type multiple myeloma associated with multiple extramedullary tumor-forming lesions and myelomatous pleural effusion and ascites is reported. The patient suffered from sternal solitary plasmacytoma, which 5 years later developed disseminated tumor formation with myeloma cells mostly in the soft tissues. At autopsy, multiple extramedullary lesions particularly in the abdominal cavity and myelomatous pleural effusion and ascites were observed without diffuse infiltration of myeloma cells in the bone marrow. The disseminating change from solitary bone plasmacytoma to extramedullary tumor formation seen in this case seemed to be unusual but suggestive of a feature of an aggressive tendency of multiple myeloma.
报告了一例罕见的IgG-κ型多发性骨髓瘤,伴有多个髓外肿瘤形成性病变、骨髓瘤性胸腔积液和腹水。患者患有胸骨孤立性浆细胞瘤,5年后发展为弥漫性肿瘤形成,骨髓瘤细胞主要存在于软组织中。尸检时,观察到多个髓外病变,特别是在腹腔内,以及骨髓瘤性胸腔积液和腹水,而骨髓中未见骨髓瘤细胞的弥漫性浸润。本例中所见的从孤立性骨浆细胞瘤向髓外肿瘤形成的播散性变化似乎不常见,但提示了多发性骨髓瘤的侵袭性倾向特征。