臨床整形外科46巻2号

2011年02月発行

症例報告

造骨性変化と溶骨性変化が混在した多発性骨髄腫の1例

著者： 畠山雄二¹ 島田洋一² 宮腰尚久² 千馬誠悦¹ 成田裕一郎¹ 宮本誠也¹ 小林志¹ 菊谷祥博³ 小野巌⁴ 東海林琢男⁴

所属機関： ¹中通総合病院整形外科 ²秋田大学大学院医学系研究科医学専攻機能展開医学系整形外科学 ³中通総合病院内科 ⁴中通総合病院臨床病理部

ページ範囲：P.167 - P.174

　症例は71歳の男性で，腰痛を訴え受診した．初診時，低蛋白血症と貧血を呈し，画像上，第2腰椎に溶骨性変化と造骨性変化を示し椎体は圧潰していた．尿中Bence Jones蛋白，血清M蛋白を認めたため多発性骨髄腫が疑われた．胸腰椎後方固定術(第12胸椎-第4腰椎)を行い，病理診断はIgG-κ型の多発性骨髄腫であった．また，左鎖骨病的骨折のため手術を要し，病巣部では仮骨形成と骨芽細胞が認められた．術後化学療法を行い，腰痛と左鎖骨部痛は改善したが，血清M蛋白は継続して認めており経過観察中である．

参考文献

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