以皮肤结节为首发症状的多发性骨髓瘤伴皮肤淀粉样变一例  

Multiple myeloma complicated by amyloidosis with cutaneous nodules as the initial manifestation:a case report

作　　者：王宇琪 丁小洁[1] WANG Yuqi;DING Xiaojie(Department of Dermatology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]川北医学院附属医院皮肤科,四川南充637000

出　　处：《中国麻风皮肤病杂志》2024年第10期725-727,共3页China Journal of Leprosy and Skin Diseases

摘　　要：多发性骨髓瘤是浆细胞恶性增殖疾病,产生大量的单克隆免疫球蛋白或片段,从而引起溶骨性病灶、贫血、高钙血症、肾功能异常等临床表现,继发淀粉样变性少见。本文报道一例以皮肤结节为首发症状的多发性骨髓瘤伴皮肤淀粉样变患者。患者,女,60岁,全身皮肤结节1年,骨髓涂片示浆细胞比例10%,其中幼浆占6%。血清蛋白电泳见M蛋白条带。免疫组化示CD38,CD138阳性。皮损组织病理示淀粉样物沉淀伴肉芽肿反应,刚果红染色(+)。患者确诊后转入血液内科进行化疗治疗,随访至今患者皮损较前消退。Multiple myeloma is a malignant proliferation disease of plasma cells,which produces a large number of monoclonal immunoglobulin or fragments,resulting in osteolytic lesions,anemia,hypercalcemia,renal dysfunction and other clinical manifestations.Secondary amyloidosis is rare.We report a case of multiple myeloma complicated by amyloidosis with cutaneous nodules as the initial manifestation.A 60-year-old female presented with cutaneous nodules all over the body for 1 year.Bone marrow biopsy showed that the proportion of plasma cells increased to 10%,of which immature plasma accounted for 6%.Serum protein electrophoresis revealed M protein bands.Immunohistochemistry showed CD38(+),CD138(+).Pathology showed amyloid deposits accompanied by granulomatous reaction,with positive Congo red staining.The patient was transferred to the department of hematology for chemotherapy after diagnosis,and the skin lesions subsided during the follow-up.

关 键 词：多发性骨髓瘤 皮肤结节 淀粉样变性 

分 类 号：R733.3[医药卫生—肿瘤] R751[医药卫生—临床医学]