伴多发性骨髓瘤的原发性系统性淀粉样变1例

Primary Systemic Amyloidosis with Multiple Myeloma:A Case Report

患者男,49岁,面部丘疹伴声嘶1年,吞咽困难2个月。查体见面颈部、躯干百余粒肤色、蜡样光泽丘疹,舌体肿大;实验室检查示:血清IgG升高,M蛋白(+)。皮损组织病理示:真皮内大量红染物质,刚果红(+),偏振光显微镜下可见苹果绿色双折光,Ⅳ型胶原(+);骨髓活检符合多发性骨髓瘤表现。诊断:原发性系统性淀粉样变。

A 49-year-old male presented with facial papules and hoarseness for one year,and dysphagia for two months.There were more than 100 fresh-color waxy papules on the face,neck and trunk,the tongue was enlarged.The serum IgG was elevated and M protein was positive.Histopathological examination demanstrated eosinophilic homogenous material in the dermis,which was positive for Congo red with apple-green birefringence on polarized light and CollagenⅣ.Bone marrow biopsy revealed as multiple myeloma.The diagnosis of primary systemic amyloidosis with multiple myeloma was made.