高龄多发性骨髓瘤鞍区占位1例
Sellar multiple myeloma in an elderly patient:a case report
陈晓雪 1段炼 1柯晓安 1阳洪波 1潘慧 1朱惠娟 1王林杰1
作者信息
- 1. 中国医学科学院 北京协和医学院 北京协和医院 内分泌科 国家卫生健康委员会内分泌重点实验室,北京 100730
- 折叠
摘要
目的 通过总结 1 例高龄多发性骨髓瘤鞍区占位患者的临床特点,增加对此类疾病的认识.方法 回顾性分析 1 例高龄多发性骨髓瘤鞍区占位患者的临床表现、生化检验、影像学资料.结果 患者为 85 岁男性,主要临床表现为乏力、纳差、多尿.辅助检查提示血钠明显降低、轻度高总蛋白及垂体占位、多项垂体前叶激素水平下降、泌乳素水平升高.完善病因筛查时发现血免疫球蛋白G(IgG)水平显著升高,血M蛋白阳性,骨髓涂片示骨髓瘤细胞,同时伴有全身骨骼多发溶骨性病变,考虑多发性骨髓瘤诊断明确,垂体占位为髓外受累可能性大.结论 鞍区占位病因多样,多发性骨髓瘤鞍区受累发生率低,起病隐匿,临床特征、影像学表现缺乏特异性,易造成误诊及漏诊.
Abstract
Objective To investigate the clinical characteristics in an elderly patient with sellar multiple myeloma.Methods Clinical features,laboratory data and radiologic profile of an elderly patient with sellar multiple myeloma were collected.Results The patient was an 85-year-old male.The main clinical manifestations were fatigue,poor appetite and polyuria.Laboratory examinations showed a significant decrease in blood sodium,several anterior pitu-itary hormones and an increase in total protein,mass of pituitary lesion and concentration of prolactin.During etio-logical screening,it was found that the blood immunoglobulin G(IgG)level was significantly increased,the blood M protein was positive and the bone marrow smear showed myeloma cells accompanied by multiple osteolytic lesions in the bones of the whole body.Considering the diagnosis of multiple myeloma,the pituitary lesion was likely to be the extra-medullary involvement.Conclusions The intrasellar plasmacytoma is not common.The disease onset is insidious with clinical features and imaging findings lacking specificity.Therefore,diagnosis relies on biopsy which poses risks for elderly patients and increases diagnostic challenges leading to misdiagnosis.
关键词
多发性骨髓瘤/鞍区占位/鞍内浆细胞瘤/高龄Key words
multiple myeloma/sellar lesion/intrasellar plasmacytoma/elderly引用本文复制引用
出版年
2025
国家科技期刊平台
NSTL
万方数据