横断脊髄麻痺を主徴とした形質細胞型の肉腫症の1剖検例

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書誌事項

タイトル別名
  • Plasma-cell Like Sarcoma Presenting as Transverse Myelopathy. Report of an Autopsied Case
  • オウダン セキズイ マヒ オ シュチョウ ト シタ ケイシツ サイボウガタ ノ

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抄録

A 44-year-old officer was admitted to the Toranomon Hospital in February 1974 because of fever, weight loss and intermittent backache. Physical examination showed temperature of 38°C., anemia, generalized lymphadenopathy, three atheroma-like subcutaneous tumors and hepatomegaly.<br>Hemoglobin was 6.5 Gm/100 ml., white cell count was 5,400 with marked shift to the left of the neutrophils and platelet count was slightly low. About 90 per cent of the nucleated cells in the aspirated marrow was identified as tumor cells.<br>Total serum protein was 6.3 Gm/100 ml. with IgG 888, IgA 669 and IgM 225 mg/100 ml. without M component. No Bence Jones protein was detected.<br>Hematoxylin-eosin stain of the biopsy materials of the skin and lymph nodes first suggested the metastatic carcinoma, but findings of the electron microscopy revealed the tumor cells were of the plasma cell origin.<br>Symptoms of transverse myelopathy appeared on March 3 and progressed rapidly. Serum acid phosphatase level was remarkably high, and he was on Hexostrol 60 mg. per day orally with prednisolone, 5-FU and cyclophosphamide. A transient recovery was achieved but he died in July 1974 after recurrent infections.<br>At autopsy extensive involvement of bone marrow with plasma-cell like sarcoma was confirmed. The disseminated infilatration was present in the central nervous system, lymph nodes, serous membranes, muscles and subcutaneous tissues. Total myelomalacia was seen under Th5. No lytic change in the bone was confirmed.

収録刊行物

  • 臨床血液

    臨床血液 17 (11), 1191-1197, 1976

    一般社団法人 日本血液学会

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