Laporan Kasus: Multiple Myeloma Non Sekretorik

Authors

  • Ihda Dian Kusuma
  • Eviana Norahmawati

DOI:

https://doi.org/10.21776/ub.jkb.2014.028.02.19

Abstract

Multiple Myeloma (MM) adalah keganasan sel plasma yang termasuk golongan Malignant Small Round Cell Tumor ditandai oleh ekspansi immunoglobulin monoklonal dan akumulasi abnormal sel plasma di dalam kompartemen sum-sum tulang. Kami laporkan kasus MM non sekretorik yang jarang ditemui yaitu pasien laki-laki 54 tahun yang datang dengan keluhan benjolan pada paha kiri dan benjolan pada bahu kanan dengan hipogammaglobulinemia dan protein Bence Jones negatif. Hasil pemeriksaan klinis, radiologi, dan biopsi menunjukkan hasil sesuai MM dengan diagnosis banding  metastase karsinoma dan Non Hodgkin's Lymphoma. Hasil pulasan immunohistokimia CD 20 (-), sitokeratin () dan LCA (-) menyingkirkan diagnosis banding dan dikonfirmasi dengan hasil biopsi sumsum tulang yaitu suatu plasmasitomatosis. Pasien didiagnosis dengan multiple myeloma non sekretorik. Dari kasus ini dapat disimpulkan bahwa pemeriksaan klinis dan penunjang sangat diperlukan untuk menegakkan diagnosis MM non sekretorik dengan tepat dan kombinasi beberapa pemeriksaan immunohistokimia dapat membantu penegakan diagnosa.

Kata Kunci: Hipogammaglobulinemia, Multiple Myeloma non sekretorik

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References

Sharma A, Kaushal M, Chaturvedi NK, and Yadav R. Cytodiagnosis of Multiple Myeloma Presenting as Orbital Involvement: A Case Report. Cytojournal. 2006; 3(19): 1-5.

Wei A and Juneja S. Bone Marrow Immunohistology of Plasma Cell Neoplasms. Journal of Clinical Pathology. 2003; 56(6): 406-411.

Ludwig H, Bolejack V, Crowley J, et al. Survival and Years of Life Lost in Different Age Cohorts of Patients with Multiple Myeloma. Journal of Clinical Oncology. 2010; 28(9): 1599-1605.

Shaw GR. Nonsecretory Plasma Cell Myeloma—becoming even more rare with Serum Free Light-Chain Assay: A Brief Review. Archives of Pathology & Laboratory Medicine. 2006; 130(8): 1212–1215.

Whicher JT, Davies JD, and Grayburn JA. Intact and Fragmented Intracellular Immunoglobulin in a Case of Non-Secretory Myeloma. Journal of Clinical Pathology. 1975; 28(1): 54-59.

Middela S and Kanse P. Non Secretory Multiple Myeloma. Indian Journal of Orthopaedics. 2009; 43(4): 408–411.

Prasad R, Yadav RR, Singh A, Mathur SP, Mangal Y, and Singh M. Case Report. Non-Secretory Multiple Myeloma Presenting with Diffuse Sclerosis of Affected Bones Interspersed with Osteolytic Lesions. The British Journal of Radiology. 2009; 82(974): 29-31.

Palumbo A and Anderson K. Multiple Myeloma. The New England Journal of Medicine. 2011; 364: 1046-1060.

Hariadi KWT, Purwanto I, Kurnianda J, Mangunsudirjo S, Harijadi A, and Puntodewo. Non Secretory Multiple Myeloma-A Case Report. Medical Journal of Indonesia. 2007; 16(4): 257-260.

Chen LP, Sun TH, Hsieh PP, Yen LJ, Lin SJ, and YU MS. Case Report Diagnostic Pitfalls of Nonsecretory Myeloma Manifesting as Multiple Foci of Periosseous Plasmacytomas. Journal of the Chinese Medical Association. 2011; 74(10): 464-468.

Maloney DG. Anti-CD20 Antibody Therapy for B-Cell Lymphomas. The New England Journal of Medicine. 2012; 366: 2008-2016.

Pernick N. Stains Cytokeratin AE1/AE3. (Online) 2013. http://www.pathologyoutlines.com/topic/stainsae1ae3.html [diakses tanggal 15 Mei 2014].

Kurtin PJ and Pinkus GS. Leukocyte Common Antigen-A Diagnostic Discriminant between Hematopoietic and Non Hematopoietic Neoplasms in Paraffin Sections Using Monoclonal Antibodies: Correlation with Immunologic Studies and Ultrastructural Localization. Human Patholology. 1985; 16(4): 353-365.

O'Connell FP, Pinkus JL, and Pinkus GS. CD138 (Syndecan-1), a Plasma Cell Marker Immunohistochemical Profile in Hematopoietic and Non Hematopoietic Neoplasms. American Journal of Clinical Pathology. 2004; 121(2): 254-263.

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Published

2014-08-26

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Section

Case Report