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多发性骨髓瘤伴恶性淋巴瘤,临床上较少见,我院收治1例,报告如下。1 病例介绍 患者,男,56岁,农民。1992年12月因乏力、头昏、胸前骨痛在某地区医院就诊。体检无特殊。血象:Hb 85g/L,WBC 11×10~9/L,plt 68×10~9/L,血沉145mm/h。蛋白电泳:A 0.461,α_10.067,α_20.067,β0.081,γ0.324。骨髓检查示:浆细胞系统显著增多,原浆0.31、幼浆0.18,成浆0.20。胸片示:部分肋骨虫蚀样破坏。诊断:多发性骨髓瘤。给予COP方案化疗1疗程,住院45天,好转出院。以后自觉仍有乏力、头昏,能自理生活及轻微劳动。至1993年5月发现左腹股沟有一肿块,逐渐增大,1993年10月来我院。体检:贫血貌,左腹股沟可及5cm×5cm大小淋巴结2枚,左下腹腹壁可及6cm×6cm肿块,均质中,活动度差,无压痛。心肺无殊,肝未及,脾肋下1.5cm、质软、无压痛。血象:Hb 80g/L、WBC 17×10~9/L,N 0.66,E 0.05,M 0.07,L 0.24,plt 31×10~9 L,ESR 112mm/h。尿蛋白(+),本周蛋白(-)。
Multiple myeloma with malignant lymphoma, clinically rare, admitted to our hospital in 1 case, the report is as follows. 1 case description Patient, male, 56 years old, farmer. December 1992 due to fatigue, dizziness, chest pain in a district hospital. No special medical examination. Blood: Hb 85g / L, WBC 11 × 10 ~ 9 / L, plt 68 × 10 ~ 9 / L, erythrocyte sedimentation rate 145mm / h. Protein electrophoresis: A 0.461, α_10.067, α_20.067, β0.081, γ0.324. Bone marrow examination showed: plasma cell system was significantly increased, 0.31 puree, juvenile 0.18, into a slurry 0.20. Chest X-ray showed: Some rib erosion samples destroyed. Diagnosis: Multiple myeloma. Given a course of COP regimen chemotherapy, hospitalized 45 days, improved discharged. After consciously still weak, dizzy, able to take care of their own life and minor labor. To 1993 May found a left groin mass, gradually increasing, in October 1993 to our hospital. Physical examination: anemia appearance, left groin and 5cm × 5cm size 2 lymph nodes, the left lower abdomen abdominal wall and 6cm × 6cm mass, homogeneous, poor mobility, no tenderness. No cardiopulmonary special, liver and spleen, rib 1.5cm, soft, no tenderness. Blood: Hb 80g / L, WBC 17 × 10 ~ 9 / L, N 0.66, E 0.05, M 0.07, L 0.24, plt 31 × 10 ~ 9 L, ESR 112mm / h. Urinary protein (+), this week’s protein (-).