内容紹介
A Case of Multiple Myeloma in a Young Adult, Discovered on the Basis of an Abnormal Finding on a Chest X-Ray Film
Summary
A 35-year-old woman was referred to our hospital because of an abnormal finding on a chest X-ray film. Chest and abdominal computed tomography(CT)revealed a 25×5-mm tumor in the anterior right third rib as well as punched-out lesions in the vertebral bodies and iliac bones. Positron emission tomography(PET)/CT revealed accumulation in the right third rib and lumbar vertebral bodies. From these imaging findings and the lumbar magnetic resonance imaging(MRI)findings, we suspected a case of multiple myeloma. We performed histological bone marrow examination, serum protein electrophoresis, and urine immunoelectrophoresis. The patient was finally diagnosed with a Bence-Jones-type multiple myeloma. To our knowledge, this is a rare case of multiple myeloma in a young adult, discovered on the basis of an abnormal finding on a chest X-ray film.
要旨
症例は35歳,女性。健康診断にて胸部X線写真での異常を指摘された。体幹部CTにて右第3肋骨前方の胸腔内へ突出する25×5 mmの腫瘤を認めるとともに,椎体や腸骨にも多発性の溶骨性変化を認めた。PET-CTでは右第3肋骨にSUVmax 2.95の集積がみられ,さらに腰椎椎体にも結節状集積がみられた。骨以外に明らかな病変を認めず,胸部および腰椎MRI所見も併せて多発性骨髄腫が疑われた。腸骨骨髄生検を行うとともに,血清蛋白電気泳動,尿免疫電気泳動を行い,Bence Jones型多発性骨髄腫の診断を得た。胸部異常陰影指摘を契機に診断に至った若年者多発性骨髄腫の1例を経験した。まれな症例と考えられ報告する。
目次
Summary
A 35-year-old woman was referred to our hospital because of an abnormal finding on a chest X-ray film. Chest and abdominal computed tomography(CT)revealed a 25×5-mm tumor in the anterior right third rib as well as punched-out lesions in the vertebral bodies and iliac bones. Positron emission tomography(PET)/CT revealed accumulation in the right third rib and lumbar vertebral bodies. From these imaging findings and the lumbar magnetic resonance imaging(MRI)findings, we suspected a case of multiple myeloma. We performed histological bone marrow examination, serum protein electrophoresis, and urine immunoelectrophoresis. The patient was finally diagnosed with a Bence-Jones-type multiple myeloma. To our knowledge, this is a rare case of multiple myeloma in a young adult, discovered on the basis of an abnormal finding on a chest X-ray film.
要旨
症例は35歳,女性。健康診断にて胸部X線写真での異常を指摘された。体幹部CTにて右第3肋骨前方の胸腔内へ突出する25×5 mmの腫瘤を認めるとともに,椎体や腸骨にも多発性の溶骨性変化を認めた。PET-CTでは右第3肋骨にSUVmax 2.95の集積がみられ,さらに腰椎椎体にも結節状集積がみられた。骨以外に明らかな病変を認めず,胸部および腰椎MRI所見も併せて多発性骨髄腫が疑われた。腸骨骨髄生検を行うとともに,血清蛋白電気泳動,尿免疫電気泳動を行い,Bence Jones型多発性骨髄腫の診断を得た。胸部異常陰影指摘を契機に診断に至った若年者多発性骨髄腫の1例を経験した。まれな症例と考えられ報告する。