オトガイ下部腫脹を主訴とした多発性骨髄腫に合併したアミロイドーシスの１例

Abstract

Amyloidosis is a disease characterized by progressive intercellular deposition of amyloid fibrilis in various tissues. It was termed like this by Virchow in the nineteenth century, because the typical tissue deposits resembled starch in iodine staining reaction.Amyloid deposits have been little known, but recently its substance has proved to be a group of highly organized fibrillar proteins by biochemical, immunological and morphological procedures. However, the pathogenesis of amyloidosis is still indefinite. We experienced a case of amyloidosis associated with multiple myeloma. The patient was a 55 year old woman who complained of tumor formation at submental region with 10-month history of dysphagia. Tumor was also seen at forearms, but macroglossia was not seen initially. About a month later, tongue was markedly swelled and indurated, and amyloid deposition was revealed by biopsy of optical and electromicroscopy specimen. Amyloid deposition was also seen in sub mental and forearm tumors.Bence-Jones protein was seen in her urine. Bence-Jones & IgA κ type monoclonal protein appeared in immunologic test. The plasma cell proliteration rate in bone marrow study showed 23.6 % with mild dysplasia.This case was diagnosed as amyloidosis associated with multiple myeloma and now treated with prodonin® and melphalan®.