Multiple Myeloma Associated with Osteosclerotic Bone Lesion Presenting as Chest Wall Masses

多發性骨髓瘤是一種蝕骨性的漿細胞腫瘤，而成骨性病灶是較罕見的。病患常以貧血，腎功能不全，骨頭疼痛及免疫不全來表現。在此我們報告一位71歲男性病患，除了兩側胸廓皮下腫塊以外無其他症狀，經過超音波引導切片及骨髓抽吸後診斷為多發性骨髓瘤合併肋骨侵犯。電腦斷層顯示腫塊呈現周邊形散在性鈣化。病理切片亦顯示過多之骨質於骨表面沉積的硬化現象。這是一個多發性骨髓瘤少見的成骨現象，因而遇瀰漫性或散在性之骨硬化時必須特別小心。以傳統化學治療甚少可完全反應：自體幹細胞移植提供治癒的可能性。因此，在遇骨硬化病灶時，仍應將較罕見的多發性骨髓瘤放入鑑別診斷。

關鍵字

神多發性骨髓瘤；骨硬化；成骨現象

並列摘要

Multiple myeloma is a plasma cell neoplasm with osteolytic bone lesion. Osteoblastic bone lesion is rare, and patients frequently present with anemia, renal insufficiency, bone pain and impaired immunity. This report describes the case of a 71-year-old man, who presented with bilateral chest wall masses, but was otherwise asymptomatic. Multiple myeloma with involvement of the ribs was diagnosed via echo-guided biopsy and bone marrow aspiration. The CT showed peripheral and scattered calcification of the mass. The pathology also displayed osteosclerosis manifesting as excess bone deposition on existing bone surfaces, a rare presentation of multiple myeloma with osteoblastic reaction, that should be borne in mind in the presence of diffuse or discrete bone sclerosis. Treatment with conventional chemotherapy rarely achieves complete remission. Autologous stem cell transplantation offers a potential cure. Although rare, multiple myeloma should be included in the differential diagnosis of osteosclerotic bone lesions.

並列關鍵字

multiple myeloma ； calcification ； osteosclerotic

國際替代計量

Multiple Myeloma Associated with Osteosclerotic Bone Lesion Presenting as Chest Wall Masses

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