伴多发性骨髓瘤的原发性系统性淀粉样变病  

Primary systemic amyloidosis with multiple myeloma:A case report

作　　者：李爱莉[1] 彭琳琳[1] 高健[1] 孙杰[1] 徐雁[1] LI Aili;PENG Linlin;GAO Jian;SUN Jie;XU Yan(Dalian Dermatosis Hospital,the Department of Venereal and Vulvar Diseases,Dalian 116021,China)

机构地区：[1]大连市皮肤病医院性病及外阴皮肤病科,辽宁大连116021

出　　处：《临床皮肤科杂志》2024年第9期540-542,共3页Journal of Clinical Dermatology

摘　　要：患者女,65岁。肛周出现扁平棕褐色丘疹半年。皮肤科检查:舌体弥漫肿大,两侧有齿痕,舌表面光滑,有蜡样结节、斑块及裂隙。外眦及耳窝处可见蜡样坚硬的丘疹,部分融合。肛周可见蜡样琥珀色坚硬丘疹、结节,部分融合成出血性斑块,弥漫性浸润。双手指可见透明样的针尖大的丘疹。皮损组织病理:真皮与皮下组织有大量不规则团块状物质沉积,结晶紫染色阳性。骨髓检查诊断为多发性骨髓瘤。转至综合医院血液科治疗,给予硼替佐米化疗。A 65-year-old woman present with flat,brown papules in her perianal region for half a year.Dermatological examination revealed a swollen tongue,diffusely enlarged,with tooth marks on both sides.The surface of the tongue was smooth,with waxy nodules,plaques and cracks.There were waxy,hard papules,partially fused,in the outer canthus and ear pits.Multiple waxy,amber,hard papules,nodules,partially coalesce to form hemorrhagic,infiltrative plaques noted in her perianal area.Clear papules,needle tip-sized,were seen on both hands.Histopathological examination showed amyloid material deposited around the vessel in the dermis.Crystal violet staining was positive.Bone marrow examination showed the changes of multiple myeloma.The patient was transferred to the hematology department of the General Hospital and given bortezomib chemotherapy.

关 键 词：淀粉样变病 系统性 原发性 骨髓瘤 多发性 

分 类 号：R739.5[医药卫生—肿瘤]