IgG4-type Multiple Myeloma with Diffuse Enlargement of the Thyroid Requiring Differentiation from IgG4-related Disease
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- Funada Masashi
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
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- Nakano Kazuhisa
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
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- Miyata Hiroko
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
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- Nawata Aya
- The Department of Pathology, School of Medicine, University of Occupational and Environmental Health, Japan
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- Tanaka Yoshiya
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
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抄録
<p>We herein report a 65-year-old man with elevated serum IgG4 levels, enlarged thyroid, and renal dysfunction, mimicking IgG4-related disease (IgG4-RD). The definitive diagnosis of IgG4-RD was not established because a tissue biopsy revealed no IgG4-positive cell infiltration or fibrosis. The presence of an M peak in the β fraction, Bence Jones protein in urine, and progressive anemia suggested multiple myeloma (MM). The κ/λ ratio was >100, tumor plasma cells were present at >20% in bone marrow, and immunostaining revealed IgG4-positive plasma cells; therefore, he was diagnosed with IgG4-type MM. Patients with elevated IgG4 levels with no significant mass lesions should undergo systemic examinations to exclude malignancy. </p>
収録刊行物
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- Internal Medicine
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Internal Medicine 59 (5), 711-714, 2020-03-01
一般社団法人 日本内科学会
