舌腫瘤が初発症状であった多発性骨髄腫の1例

A case of multiple myeloma manifested by multiple tongue masses

I．はじめに

　多発性骨髄腫は，骨髄において形質細胞が腫瘍性増殖し，さまざまな症状を呈する疾患である。一般に，骨破壊に伴う疼痛，高カルシウム血症による症状，貧血症状などが特徴的であり，口腔病変が初発であることは少ない。今回，われわれは舌腫瘤が初発症状であった舌アミロイドーシスを呈した多発性骨髄腫症例を経験したので，若干の文献的考察を加えて報告する。

A 73-year-old male found tongue masses one year ago,but he left it without any examinations. He consulted an orthopedic clinic several months ago with a pain in the right thigh,and a swelling and pain in the right shoulder joint next year. He was suspected of metastatic bone tumor and underwent a biopsy of the joint mass,however the pathological diagnosis was necrotic tissue. Excisional biopsy of the tongue mass was carried out,and the pathological examinations showed amyloidosis. Additional immunological examinations revealed kappa type Bence Jones protein in urine and he was diagnosed of multiple myeloma associated with amyloidosis.