多发孤立性浆细胞瘤伴维生素D缺乏

Multiple solitary plasmacytoma associated with vitamin D deficiency

多发孤立性浆细胞瘤(MSP)发病率低,相关报道罕见。本文报道1例63岁女性患者,右下肢针刺样疼痛2月余,伴麻木、乏力。实验室检查提示高甲状旁腺激素血症,血清骨源性碱性磷酸酶升高,维生素D缺乏。神经肌电图显示右下肢神经源性损害。骶椎、骨盆CT增强提示骶1椎体右侧见软组织团片灶,呈膨胀性骨质破坏,骨皮质破裂。18 F-FDF PET/CT显示胸骨、胸、腰椎椎体、左侧髂骨及右侧骶骨骨质破坏影。CT引导下经皮穿刺活检免疫组化显示浆细胞骨髓瘤、CD138(+)、MUM-1(+)、Lambda(+)。结合骨髓涂片等结果该病例诊断为多发孤立性浆细胞瘤。

The multiple solitary plasmacytoma （ MSP） is rare.Here we reported a case of 63-year-old female presented with stabbing pain of the right lower limb more than two month , accompanied by numbness , weakness .Laboratory examination showed high serum parathyroid hormone （ PTH） level, elevated serum bone alkaline phosphatase .Vitamin D deficiency was also found in this patient .EMG revealed right lower extremity neurogenic damage .The bone destruction expansive , rupture of cortical bone with the soft tissue group piece stove were shown in the right side of S 1 vertebral body by enhanced CT .18 F-FDF PET /CT display sternum , multiple thoracic and lumbar vertebrae , the left iliac and right side of the sacrum bone destruction shadow .Biopsy of CT guided percutaneous and immunohistochemistry showed plasma-Cell Myeloma , CD138 （＋） , MUM-1 （＋） , and Lambda （＋） .The case was diagnosed as MSP combined bone marrow smears with the other results .