多发性骨髓瘤1例

患者男,44岁。主因前胸后背疼1个月来就诊,摄左肩关节正位片示:左肩胛骨、左锁骨、左肱骨上段见多发斑片状、穿凿样骨质破坏区,部分边缘清晰,部分融合成片,骨皮质尚光整,(图1)建议CT扫描,CT示颅面骨、多发肋骨、椎     

92例多发性骨髓瘤临床X线分析

９２例多发性骨髓瘤临床Ｘ线分析丁建平任庆云李彦格康胜群刘秀健赵静品封彦祥王溱多发性骨髓瘤（简称ＭＭ）是一种常见的恶性肿瘤，其发病率较其他全部恶性骨肿瘤的总和还多［１］。本病国外报道甚多［２］，笔者搜集到经骨穿或活检证实的ＭＭ９２例，报告如下。一、临床...     

多发性骨髓瘤9例误诊分析

多发性骨髓瘤（MM）临床症状多隐匿或不典型，在合并多脏器损害后，常常以某一症状就诊。患者或医生因缺乏对本病系统损害的认识，屡致误诊而延误治疗，为引起同道们的重视，现报道我院9例误诊病例。目临床资料1．1一般情况9例初次就诊时分别以不同的症状在骨科、呼吸科、肾内科、急诊科、血液科治疗，并有各种不同的误诊，以后经过详细的临床检查，血液、骨髓X线片检查均确诊为MM，诊断符合国内统一标准“’。其中男4例，女5例；年龄38～61岁，平均52．9岁。确诊前病程2～10个月，平均4．3月。1·2初次就诊情况见附表。1．3实验室检查贫…     

多发性骨髓瘤误诊一例

患者　男 ,1 9岁。因右下肢疼痛 2月余就诊。查体 :右下肢活动受限 ,右股骨远段 ,胫骨近段、远段和腓骨远段局限性压痛 ( + ) ,局部皮肤无红、肿、热胀感 ,未扪及软组织肿块。实验室检查无异常。X线表现 :双侧胫、腓骨正侧位、右股骨下段正位片示右股骨远段、右胫骨干骺端、胫骨腓骨下段髓腔内偏侧性多发长、扁圆形、境界清楚的骨质缺损区 ,自髓腔向骨皮质内板侵犯 ,皮质变薄 ,周围无骨硬化区。头颅侧位和骨盆正位片均未见异常。脊椎侧位片未见异常。所示平片均未见软组织肿块影。入院 2周后行胫骨干骺端肿瘤活检术 ,病理证实为多发性骨髓…     

Orbital involvement by multiple myeloma: case report

A case of orbital myeloma in a patient with myelomatosis is discussed. Extraskeletal spread to the orbit has rarely been reported. In a patient with proptosis and known multiple myeloma, an orbital mass can be presumed to be orbital involvement by myeloma.     

多发性骨髓瘤误诊为多发性骨转移1例

男,84岁,2003年12月15日因"腰背痛1月"住院.其疼痛呈持续性钝痛,不向他处放射.一年半前患者因肉眼血尿经膀胱镜活检诊为移行细胞癌,后行膀胱癌部分切除术未再发现癌细胞.术后丝裂霉素20 mg每月1次膀胱灌注,定期复查膀胱镜未见复发.患者有老慢支病史30年.     

Orbital multiple myeloma: case report and review of computed tomography features

Orbital involvement at diagnosis in multiple myeloma is rare. Only a few a cases are reported with computed tomographic features. We report a case of orbital myeloma, and relevant medical reviews on computed tomography features are discussed.     

Imaging in multiple myeloma

In multiple myeloma, imaging is required to determine the stage of disease and to anticipate impending bone fractures. Whereas the traditionally used Durie and Salmon staging system includes lytic bone lesions in plain films as criteria, modern systems include MRI findings. MRI is most sensitive to both diffuse bone marrow involvement as well as solid plasma cell tumors. Whole-body low-dose CT (WBCT) may replace plain films in the near future, since it is quicker, more sensitive and is better tolerated by patients. Intramedullary lesions are well seen as long as they are located in long bones where they are surrounded by fat. Diffuse bone marrow infiltration as well as intravertebral lesions, however, are difficult to detect with WBCT in the absence of frank destruction of cancellous bone. PET or PET-CT with 18-fluoro-deoxyglucose (FDG) are insensitive to diffuse bone marrow infiltration, but may help to assess treatment response in solitary or multiple solid plasma cell tumors which have a high FDG uptake before treatment.     

Hyperparathyroidism accompanying multiple myeloma

Hypercalcemia is a manifestation of a variety of both benign and malignant diseases. These conditions are not mutually exclusive, and we present a case report of a patient first diagnosed with the classic findings of multiple myeloma who, after appropriate therapy, demonstrated persistent hypercalcemia and was found on further testing to have an elevated parathormone level (PTH) and scintigraphic evidence of a benign parathyroid adenoma. Hypercalcemia responded to excision of the parathyroid adenoma. There are only 18 similar cases reported in the medical literature.