Multiple myeloma is a malignant disorder which is characterized by an uncontrolled proliferation of plasma cells in bone marrow. Primary amyloidosis can either arise idiopathically or can be associated with plasma cell discrasia (1,2). Here we present a patient with amyloidosis of the tongue which developed as a complication of multiple myeloma. Case Report A 73-year-old man admitted to our clinic with macroglossia and asymptomatic multiple ulcerated nodular lesions on his tongue which first appeared 4 months ago and enlarged gradually. He complained of difficulty in speech and swallowing solid foods. His past medical history revealed multiple myeloma which was diagnosed one year ago and he was still being treated with pulsed courses of vincristine, adriamycine, dexamethasone and pamidronate disodium. His dermatologic examination revealed slight macroglossia and multiple shiny, reddish-purple, ulcerated nodular lesions on the lateral borders ofhis tongue (Figure 1). Apart from slight anemia and high erythrocyte sedimentation rate, laboratory examinations including complete blood count, serum biochemistry, urine analysis and protein electrophoresis were all normal. An incisional biopsy was made from one ofthe nodular lesions under the diagnostic possibilities of hemangioma, lymphangioma, plasmasitoma and amyloidosis. Dermatopathological examination of the biopsy 197 HAT CE A N LI , P E L N E K ME KC , ERDN TERZ , C EN G ZH AN ER DE M Hatice Şanlı* ✥ Pelin Ekmekci** ✥ Erdinç Terzi*** ✥ Cengizhan Erdem**** 197 Y.A d, Y.Ad A CASE OF MULTIPLE MYELOMA AND AMYLOIDOSIS OF THE TONGUE ––––––––––––––––––––––––– *Dept. of Dermatology, School of Medicine, A nkara University, Assoc. Pr ofessor**Dept. of Dermatology, School of Medicine, Ankara University, Instructor*** Dept. of Dermatology, School of Medicine, Ankara University, Resident**** Dept. of Dermatology, School of Medicine, Ankara University, Professor––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––Received: Dec 07, 2001 Accepted: March 11, 2002JOURNAL O F ANKARA MEDICAL SCHOOL Vo l 2 4 , N o 4 , 2 0 02 197-200 SUMMARYMultiple myeloma is a clonal plasma cell proliferativedisorder. Ten to fifteen per cent of patients with multiplemyeloma have associated primary amyloidosis. Wedescribe a case of oral amyloidosis presented with macroglossia and characteristic nodular lesions which developed as a complication of multiple myeloma. Pathogenesis, diagnosis and treatment of oralamyloidosis are also discussed. Key Words:Amyloidosis, Tongue, Multiple Myeloma. ÖZETBir Multipl Myeloma ve Dilde Amiloidozis OlgusuMultiple myeloma klonal plazma hücre proliferasyonuile karakterize bir hastalıktır ve multipl myelomalı hastaların %10-15’inde primer amiloidozisgelişmektedir. Bu makalede multiple myelomanın komplikasyonu olarak dilde makroglossi ve karakteristiknodüler amiloidosis lezyonları meydana gelen bir olgusunulmuş ve oral amiloidozis patogenezi, tanısı vetedavisi kısaca gözden geçirilmiştir. Anahtar Kelimeler:Amiloidozis, Dil, Multipl Myeloma
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A CASE OF MULTIPLE MYELOMA ANDAMYLOIDOSIS OF THE TONGUE
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*Dept. of Dermatology, School of Medicine, Ankara University, Assoc. Professor
**Dept. of Dermatology, School of Medicine, Ankara University, Instructor
*** Dept. of Dermatology, School of Medicine, Ankara University, Resident
**** Dept. of Dermatology, School of Medicine, Ankara University, Professor –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Received: Dec 07, 2001 Accepted: March 11, 2002
JOURNAL OF ANKARA MEDICAL SCHOOL Vol 24, No 4, 2002 197-200
SUMMARY
Multiple myeloma is a clonal plasma cell proliferative disorder. Ten to fifteen per cent of patients with multiple myeloma have associated primary amyloidosis. We
describe a case of oral amyloidosis presented withmacroglossia and characteristic nodular lesions whichdeveloped as a complication of multiple myeloma.Pathogenesis, diagnosis and treatment of oral amyloidosis are also discussed.
Key W or ds: Amyloidosis, Tongue, Multiple Myeloma.
ÖZE T
Bir Multipl Myeloma v e Dilde Amiloidozis Olgusu
Multiple myeloma klonal plazma hücre proliferasyonu
ile karakterize bir hastalıktır ve multipl myelomalıhastaların %10-15’inde primer amiloidozis gelişmektedir. Bu makalede multiple myelomanınkomplikasyonu olarak dilde makroglossi ve karakteristik nodüler amiloidosis lezyonları meydana gelen bir olgu sunulmuş ve oral amiloidozis patogenezi, tanısı ve tedavisi kısaca gözden geçirilmiştir.