Huang J S, Ho Y P, Ho K Y, Wu Y M, Chen C C, Wang C C, Tsai C C, Lin S F
Department of Periodontology, School of Dentistry, Kaohsiung Medical College, Taiwan, Republic of China.
Kaohsiung J Med Sci. 1997 Jun;13(6):388-94.
Multiple myeloma is a neoplastic disorder of bone that originates from cells of bone marrow. It is most commonly seen within the age range of 50-80 years, cases under the age of 40 being rare. Men are affected more frequently than are women. Bone pain is the cardinal clinical symptom in multiple myeloma. Because of the destruction of bone, pathologic fracture is fairly common. In the oral manifestations, the mandible is involved far more frequently than the maxilla, especially the most active hematopoietic areas-the remus, angle and molar region of the mandible. Other signs and symptoms of jaw involvement include swelling, pain, and increased tooth mobility. Extraosseous lesions may result in paresthesia of soft tissue and gingival enlargement with bleeding tendency. Roentgenographic examination will usually reveal numerous punched-out lesions in a variety of bones. In addition, blood examination will reveal hyperglobulinemia and Bence-Jones protein may be present in the urine of myeloma patients. The histological features of myeloma are closely packed cells resembling plasma cells. Case 1 in this report is a 64-year-old female, who has been diagnosed as having multiple myeloma (IgG, lambda). She was referred to our hospital because of gingival swelling, bleeding and pain. Case 2 is a 60-year-old female suffering from spontaneous gingival bleeding. After blood, urine examination and bone marrow biopsy, multiple myeloma was diagnosed (IgG, lambda). This paper reports the clinical manifestations and treatment courses of these two cases, and the concerns of treatment of multiple myeloma are also discussed.
多发性骨髓瘤是一种起源于骨髓细胞的骨肿瘤性疾病。最常见于50 - 80岁年龄段，40岁以下病例罕见。男性比女性更易受累。骨痛是多发性骨髓瘤的主要临床症状。由于骨质破坏，病理性骨折相当常见。在口腔表现方面，下颌骨受累远比上颌骨频繁，尤其是下颌骨最活跃的造血区域——下颌支、角部和磨牙区。下颌骨受累的其他体征和症状包括肿胀、疼痛和牙齿松动增加。骨外病变可能导致软组织感觉异常和牙龈肿大并有出血倾向。X线检查通常会显示多种骨骼中有大量的穿凿样病变。此外，血液检查会显示高球蛋白血症，骨髓瘤患者尿液中可能存在本-周蛋白。骨髓瘤的组织学特征是紧密排列的细胞类似浆细胞。本报告中的病例1是一名64岁女性，已被诊断为患有多发性骨髓瘤（IgG，λ型）。她因牙龈肿胀、出血和疼痛转诊至我院。病例2是一名60岁女性，患有自发性牙龈出血。经过血液、尿液检查及骨髓活检，诊断为多发性骨髓瘤（IgG，λ型）。本文报告了这两个病例的临床表现和治疗过程，并讨论了多发性骨髓瘤治疗中的关注点。
