{"created":"2023-06-19T10:29:49.006668+00:00","id":1922,"links":{},"metadata":{"_buckets":{"deposit":"91f1da04-09c8-4993-a6e6-4d9aac630405"},"_deposit":{"created_by":31,"id":"1922","owners":[31],"pid":{"revision_id":0,"type":"depid","value":"1922"},"status":"published"},"_oai":{"id":"oai:kwmed.repo.nii.ac.jp:00001922","sets":["1709617079800:35:616:617"]},"author_link":["110207","110208","110209","110210","110211","110212","110213","110214","110215","110216","110217","110218","110219","110220","110221","110222","110223","110224","110225","110226","110227","110228","110229","110230","110231","110232","110233","110234","110235","110236"],"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2018","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"64","bibliographicPageStart":"57","bibliographicVolumeNumber":"44","bibliographic_titles":[{"bibliographic_title":"川崎医学会誌","bibliographic_titleLang":"ja"},{"bibliographic_title":"Kawasaki medical journal","bibliographic_titleLang":"en"}]}]},"item_10001_description_33":{"attribute_name":"記事種別(日)","attribute_value_mlt":[{"subitem_description":"症例報告","subitem_description_language":"ja","subitem_description_type":"Other"}]},"item_10001_description_34":{"attribute_name":"記事種別(英)","attribute_value_mlt":[{"subitem_description":"Case 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of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Urology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Urology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"}]},"item_10001_textarea_5":{"attribute_name":"抄録(英)","attribute_value_mlt":[{"subitem_textarea_language":"en","subitem_textarea_value":"　Urothelial cancer cells may appear similar to plasma cells. We present a case of plasmacytoid bladder cancer with bone marrow metastasis and difficult morphological differentiation from myeloma. A male in his 80s presented with proteinuria and renal dysfunction in October 20XX. Detailed examination led to a diagnosis of International Staging System Stage II multiple myeloma (IgG-λ), and BD (bortezomib + dexamethasone) therapy was started. Three courses of treatment resulted in a very good partial response. Intermittent hematuria was observed in February 20XX+1, and cytodiagnosis and cystoscopy confirmed bladder cancer. Myeloma treatment was discontinued, and treatment of bladder cancer was prioritized. There was no metastasis to lymph nodes or other organs on positron emission tomography-computed tomography (PET/CT) and cystectomy was performed in June. The postoperative course was good, and myeloma treatment was to resume once the patient had improved. However, in late September, he developed lower back pain that intensified in October. Repeat PET/ CT confirmed multiple bone marrow lesions. Exacerbation of myeloma was suspected. Bone marrow aspiration confirmed multiple plasma cell-like atypical cells, indicating exacerbation of myeloma. However, other myeloma-related tests performed at the same time, including IgG and immunoglobulins, were normal, and M protein was not detected on protein fractionation or immunofixation. Histopathological examination of a bone marrow biopsy showed that plasma cell-like atypical cells were urothelial tumor cells, and bone metastasis from bladder cancer was diagnosed. Multiple bone marrow lesions found on PET/CT were not an exacerbation of multiple myeloma but instead were multiple bone metastases from bladder cancer.\n　Recurrence following cystectomy has a high prevalence of distant metastasis (20 to 50%), and distant metastasis sites include bones, lymph nodes, lungs, and liver in the order of prevalence. Therefore, bone marrow aspiration and histological examination with immunostaining, in addition to serum and urine protein analysis are essential to prevent confusion with myeloma cells."}]},"item_10001_textarea_6":{"attribute_name":"抄録(日)","attribute_value_mlt":[{"subitem_textarea_language":"ja","subitem_textarea_value":"　尿路上皮癌には，腫瘍細胞が形質細胞に酷似した形態を呈することがある．今回，形態学的に骨髄腫細胞との鑑別に苦慮したplasmacytoid な形態を示した膀胱癌の骨髄転移の一例を経験したので報告する．\n　症例は80歳代男性で，20XX 年10月に蛋白尿と腎機能障害が出現し，精査にて多発性骨髄腫（IgG-λ），ISS Ⅱ期と診断され，BD 療法（bortezomib+dexamethasone）を開始した．効果は良好で，３コース施行後にはVGPR（very good partial response）に到達した．20XX ＋１年２月間歇的に認めていた血尿の精査を行い，細胞診や膀胱鏡検査から膀胱癌の併発を確認した．骨髄腫治療は中断し，膀胱癌治療を優先した．PET/CT 検査ではリンパ節やその他臓器への転移は認めず，６月に膀胱全摘術が施行された．術後は経過良好であったため，全身状態の回復を待ち，骨髄腫治療を再開する予定であった．しかし，９月末頃から腰痛が出現し，10月には腰痛の増強を認めたため再度PET/CT 検査を施行したところ，多発する骨髄病変を認めた．骨髄腫の増悪を疑い骨髄検査を施行した．骨髄穿刺塗沫標本では，形質細胞様の異形細胞を多数認め，骨髄腫の増悪を推測させる所見であった．しかし同時に施行された骨髄腫関連検査では，IgG やその他の免疫グロブリンは正常であり，蛋白分画や免疫固定法でもM 蛋白は検出されなかった．骨髄生検の病理組織学的検査の結果，形質細胞様の異形細胞は尿路上皮系の腫瘍細胞であり，膀胱癌の骨転移と診断された．PET/CT 検査での多発骨髄病変は，多発性骨髄腫の増悪ではなく，膀胱癌の多発骨転移であった．\n　膀胱全摘後の再発は，遠隔転移が20～50% と遠隔転移が多く，遠隔転移部位として骨，リンパ節，肺，肝の順に多いと報告されている．そのため，骨髄塗抹標本検鏡の際，遭遇する可能性があり，骨髄腫細胞と見誤らないためには，免疫染色を含めた組織学的な検討，血清・尿の蛋白解析が必須と考えられた． "}]},"item_10001_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"佐野, 史典","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"横井, 桃子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"松本, 誠司","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"安井, 晴之進","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"内田, 圭一","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"清水, 里紗","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"廣瀬, 匡","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"竹内, 麻子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"徳永, 博俊","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"近藤, 敏範","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"松橋, 佳子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"藤田, 雅一郎","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"宮地, 禎幸","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"和田, 秀穂","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"杉原, 尚","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"SANO, Fuminori","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"YOKOI, Momoko","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"MATSUMOTO, Seiji","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"YASUI, Harunoshin","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"UCHIDA, Keiichi","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"SHIMIZU, Risa","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"HIROSE, Tadashi","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"TAKEUCHI, Asako","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"TOKUNAGA, Hirotoshi","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"KONDO, Toshinori","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"MATSUHASHI, Yoshiko","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"FUJITA, Masaichiro","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"MIYAJI, Yoshiyuki","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"WADA, Hideho","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"SUGIHARA, Takashi","creatorNameLang":"en"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-03-14"}],"displaytype":"detail","filename":"KMJ-J44(1)57.pdf","filesize":[{"value":"1.6 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"PDF","objectType":"fulltext","url":"https://kwmed.repo.nii.ac.jp/record/1922/files/KMJ-J44(1)57.pdf"},"version_id":"b5be854f-9b67-4747-ba9b-4f8bb06f4b33"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"膀胱癌","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"骨転移","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"骨髄腫細胞","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"Badder carcinoma","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Bone metastases","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Myeloma cell","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"形態学的に骨髄腫細胞との鑑別に苦慮した plasmacytoid な形態を示した膀胱癌の多発骨転移の１例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"形態学的に骨髄腫細胞との鑑別に苦慮した plasmacytoid な形態を示した膀胱癌の多発骨転移の１例","subitem_title_language":"ja"},{"subitem_title":"Multiple bone metastases of plasmacytoid bladder carcinoma that was morphologically difficult to distinguish from myeloma cells","subitem_title_language":"en"}]},"item_type_id":"10001","owner":"31","path":["617"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2019-03-14"},"publish_date":"2019-03-14","publish_status":"0","recid":"1922","relation_version_is_last":true,"title":["形態学的に骨髄腫細胞との鑑別に苦慮した plasmacytoid な形態を示した膀胱癌の多発骨転移の１例"],"weko_creator_id":"31","weko_shared_id":-1},"updated":"2024-04-12T07:31:22.001502+00:00"}