尿中に大型で多核化した大食細胞を認めたIgD-λ型多発性骨髄腫の一例

• Published in: Japanese Journal of Medical Technology Vol. 68; no. 1; pp. 199 - 206
• Main Authors: 田中, 敏典, 石澤, 春美, 羽角, 安夫, 菊地, 雅寛, 田村, 幸穂, 角張, 純, 久保, 陽子
• Format: Journal Article
• Language: Japanese
• Published: 一般社団法人 日本臨床衛生検査技師会 25.01.2019; 日本臨床衛生検査技師会; Japanese Association of Medical Technologists
• Subjects: macrophage; multipule myeloma; the qualitative urin test; the quantitative urin test; urine sediment examination; 多発性骨髄腫; 大食細胞; 尿定性検査; 尿定量検査; 尿沈渣検査
• ISSN: 0915-8669; 2188-5346
• DOI: 10.14932/jamt.18-82

The patient was a 40-year-old male who was admitted to our hospital because of pain in his left chest in 201X. He was diagnosed as having multiple myeloma from the results of bone marrow examination. There was no significant difference between the qualitative and quantitative urine test results when he was hospitalized. Large polynuclear macrophages and casts were observed during urine sediment examination, which suggested myeloma kidney due to multiple myeloma. Thus, there is a possibility of merging of myeloma kidney and it is important to detect this. 症例は40歳代，男性。201X年に左前胸部痛を自覚し健診異常で紹介受診となり，骨髄検査の結果多発性骨髄腫と診断された。入院時の尿検査で尿蛋白定性検査と尿蛋白定量検査の乖離を認めなかった。また，尿中に大型で多核化した大食細胞が円柱と共に認められた場合，多発性骨髄腫による骨髄腫腎を合併している可能性を示唆しており検出することは重要であると考える。