孤立性骨髄腫(BJ-λ)で発症し，5年の経過後広範な髄外腫瘤の形成が認められた興味ある一剖検例

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タイトル別名
  • A Case of Solitary Myeloma with Marked Extramedullary Lesions in the Terminal Stage
  • 孤立性骨髄腫(BJ-λ)で発症し,5年の経過後広範な髄外腫瘤の形成が認められた興味ある1剖検例
  • コリツセイ コツズイシュ BJ ラムダ デ ハッショウシ 5ネン ノ ケイカゴ

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A 49-year-old man was admitted to our hospital because of a painful lump over the sternum in September, 1975. There was a smooth, elastic hard, 5 by 7 cm mass over the sternum without other abnormalities of physical findings. Skeletal roentgenograms showed an osteolytic lesion only in the sternum. The urine contained 0.24g/day of Bence Jones (λ) protein. There were no abnormalities in the peripheral blood picture and serum electrophoretic pattern. The bone marrow aspirate from the sacrum contained only 2.0 per cent plasma cells with no atypism. Surgical biopsy of the sternal tumor revealed the sarcomatous growth of plasma cells. Then diagnosis of solitary myeloma (BJ-λ) was made. The tumor promptly subsided following chemotherapy.<br>In July, 1980 as well as in June, 1979, the sternal tumor relapsed, but it promptly subsided following the institution of chemotherapy and/or radiation therapy. In November, 1980, the patient developed liver tumors, and subsequently abdominal tumor and ascites. Through various studies on tumor cells in the ascites, they were found to be of plasma cell origin.<br>In April, 1981, the patient died of cachexia. At autopsy, multiple tumor-formations by myeloma cells were found in the abdominal cavity, liver, retroperitoneum, diaphragma, left-adrenal gland, mediastinum and lymph nodes. There was no infiltration of myeloma cells in any other bones except for the sternum.<br>During the whole course of the disease, the repeated bone marrow aspirates contained only 1.0 to 3.2 per cent plasma cells with normal appearance and repeated skeletal roentgenograms showed no osteolytic lesions except for the sternum.

収録刊行物

  • 臨床血液

    臨床血液 23 (6), 898-906, 1982

    一般社団法人 日本血液学会

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