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| A case of multiple myeloma starting with thoracic spine mass |
| YI Wen-jing1 WANG Yi1 LIU Song-shan1 DENG Jie2 |
| 1.Department of Hematology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan Province, Chengdu 610075, China;
2.Department of General Medicine, Chengdu Second People′s Hospital, Sichuan Province, Chengdu 610021, China |
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Abstract The paper reported a case of multiple myeloma (MM) admitted to Affiliated Hospital of Chengdu University of Traditional Chinese Medicine with thoracic mass as the first case.Combined with relevant literature review, the clinical manifestations, disease characteristics, prognosis and treatment options of MM and extramedullary plasmacytoma (EMP) were differentiated, so as to reduce clinical misdiagnosis and mistreatment.A 57 years old male patient presented to the orthopedics department due to repeated weakness of both lower limbs at the first episode.The abnormal signal of the 6th thoracic vertebrae and appendages was found by MRI.The nature of the lesion did not exclude tumor lesions, and pathology after lumpectomy was performed.The biopsy showed diffuse infiltration of plasma cell-like cells, and immunohistochemistry mainly expressed plasma cell markers, considering plasma cell tumors;further improvement of serum protein electrophoresis revealed an abnormal increase in M protein,and serum immunofixation electrophoresis showed IgG LAM type M protein (+), bone marrow biopsy revealed a small number of CD138(+), Igκ(+) or Igλ (+) plasma cells scattered and distributed.For the diagnosis of malignant plasmacytoma, EMP is more likely to be considered.Long-term regular oral administration of lenalidomide and dexamethasone outside the hospital.The disease has progressed in the past two years after the control of the disease, and the bone marrow smear and flow cytometry have confirmed the abnormal increase of clonal plasma cells.
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