Amyloidosis is a disease characterized by deposition of extracellular fibrillar proteins in various tissues mainly derived from the mesoderm. We experienced a case of a 59-year old man with a localized bilateral mass at the angle of the mouth, which was surgically removed. It surrounded the facial arteries bilaterally with the same pattern, and was diagnosed as amyloidosis pathologically. Followed by further workup, he was finally diagnosed with the multiple myeloma. Cases such as this where an amyloidosis mass surrounded the main branches of the facial arteries has not yet been reported in the literature. We present a case of localized amyloidosis at the oral commisure surrounding the facial arteries with the review of its clinical patterns, diagnostic tools, pathologic findings and treatment.
Amyloidosis ; Arteries ; Mesoderm ; Mouth ; Multiple Myeloma ; Proteins

This study was purposed to investigate the expression of heat shock protein 90 (HSP90) in peripheral blood plasma of patients with multipl myeloma (MM), and to explore its possible role in the pathogenesis of MM, and its relationship with treatment, prognosis and the outcome of patients. The peripheral blood samples from 58 patients with MM and 20 healthy volunteers were collected. The plasma concentration of HSP90 in patients and healthy volunteers was measured by ELISA. The results showed that the concentration of HSP90 in peripheral blood of patients with MM was significantly higher than that in the healthy volunteers [(32.398 ± 3.674) vs (25.762 ± 2.916) ng/ml] (P < 0.001). The concentration of HSP90 showed positively correlation with International Staging System(ISS) stage, therapeutic response, frequency of plasmocyte, globulin, immune globulin, M-protein, β2 micro-globulin, and light chain of MM patients (P < 0.05) ; while it showed little correlation with sex, age and type of MM patients (P > 0.05) . It is concluded that the HSP90 may be involved in the occurrence and development of MM. Detection of HSP90 in plasma would contribute to judge the clinical course, therapeutic efficacy and prognosis of MM patients.
HSP90 Heat-Shock Proteins ; blood ; Humans ; Multiple Myeloma ; blood ; Myeloma Proteins ; Prognosis

Two M-protein peaks in serum protein electrophoresis are rarely present in patients with plasma cell discrasia. We describe a 72-year-old male patient with multiple myeloma secreting biclonal M-proteins, which were confirmed by immunofixation. Immunoelectrophoresis has some difficulties to dectect M components when a very small amount of M-protein develops an equivocally abnormal precipitation arc. In this case, serum protein electrophoresis revealed two M peaks, one in beta and the other in gamma globulin region. An immunoelectrophoresis revealed unequivocally abnormal precipitation arcs in IgA and K light chain regions, but the arc in IgG region was equivocal. We performed an immunofixation and confirmed biclonal gammopathy, IgA-K and IgG-K types. This result supports the view that immunofixation is an useful confirmatory test when immunoelectrophoresis results are equivocal.
Aged ; Electrophoresis ; gamma-Globulins ; Humans ; Immunoelectrophoresis ; Immunoglobulin A ; Immunoglobulin G ; Male ; Multiple Myeloma* ; Myeloma Proteins ; Plasma Cells

No abstract available.
Multiple Myeloma* ; Oncogene Proteins* ; Oncogenes* ; Proliferating Cell Nuclear Antigen*

Humans ; Multiple Myeloma ; Clinical Relevance ; Microfilament Proteins ; Biomarkers, Tumor

Multiple myeloma(MM) as one of the most common tumors of hmatologic system, is characterized by malignant proliferation of plasma cells, and the chemotherapy is the main therapeutic method. MM is an incurable disease because of drug-resistance of MM cells. Although the pathogenesis of MM remains unknown, the chromosome abnormalities exit in half of the patients, particularly the highly expressed gene C-MYC. Furthermore, plenty of clinical researches indicated a high expression level of C-MYC implied worse progression and/or poor prognosis of MM. Recently, the work exploiting the compounds targeting MYC has made substantial progress, even in the MM therapy. In this article, briefly the recent advances of the research on C-MYC proto-oncogene in multiple myeloma are reviewed.
Chromosome Aberrations ; Genes, myc ; Humans ; Multiple Myeloma ; Plasma Cells ; Proto-Oncogene Proteins c-myc

OBJECTIVETo investigate the expression of PIGF and its receptor Flt-1 in patients with multiple myeloma, and to analyze their correlation with the efficacy of thalidomide-based chemotherapy so as to provide further theoretical basis for individualized treatment.

METHODSA total of 35 patients diagnosed as multiple myeloma from June 2012 to March 2013 in our hospital and 15 non-tumor patients as controls were enrolled in this study. MM patients were treated with thalidomide-based chemotherapy for 3 months, and then were grouped according to the curative effecacy. The expression levels of PIGF and Flt-1 were detected in bone marrow of control and MM patient group by RT-PCR and Western blot before and after chemotherapy, their correlation with chemotherapeutic efficacy was analyzed. Serum concentrations of PITG and Flt-1 were detected in control and MM patients before and after chemotherapy by ELISA and their correlation with the chemotherapeutic efficacy was analyzed.

RESULTSThe effective rate of three-months-thalidomide-based chemotherapy was 54.3% in MM patients. The expression levels of PIGF and Flt-1 in MM patients' bone marrow were obviously higher than those in controls. After chemotherapy, PIGF and Flt-1 expression levels significantly reduced and the decline level was positively correlated with curative effecacy(r=0.71). The serum concentrations of PIGF and Flt-1 in MM patients' bone marrow were obviously higher than those in control. After chemotherapy, serum concentrations of PIGF and Flt-1 were significantly decreased and the decline level positively correlated with curative effecacy(r=0.87).

CONCLUSIONPIGF and FLT-1 are highly expressed in patients with multiple myeloma, and their expression levels positively correlates with curative effecacy of thalidomide-based chemotherapy.

OBJECTIVETo investigate the relationship of WT1 and VEGF expression with angiogenesis in bone marrow biopsies of multiple myeloma patients.

METHODSVEGF, WT1 expression and microvessel density (MVD) of 62 cases of multiple myeloma and 10 normal bone marrow tissue were detected by in situ hybridization and immunohistochemistry SP method.

RESULTSMicrovessel density (MVD) of the control group was (45±6)/visual field, and while MVD of the multiple myeloma group was (84±26)/sight, and statistical analysis showed that MVD in multiple myeloma group was significantly higher than that in control group (P<0.05); in 62 cases of multiple myeloma the VEGF positive rate was 51.6% (32/62), and MVD in VEGF-positive group was significantly higher than that in the negative group (P<0.05). WT1 positive rate was 30.6% (19/62), and MVD in WT1-positive group was significantly higher than that in the negative group (P<0.05). And statistical analysis showed that WT1 expression significantly correlated with VEGF expression (P<0.05).

CONCLUSIONWT1 high expression of multiple myeloma bone tissue can up-regulate VEGF expression and promote angiogenesis.

OBJECTIVE: To explore the effects of different concentration of pomalidomide on human multiple myeloma cell line MM1.S and the expression of CRBN. METHODS: CCK-8 method was used for detecting inhibition effect of promalidomide on proliferation of MM1.S cells. Apoptosis rate of MM1.S cells was detected by flow cytometry with Annexin V-FITC/PI double staining. Real-time quantitative PCR was used to determine CRBN gene expression level. Western blot was used to detect the effect of pomalidomide on the protein expression of CRBN in MM1.S cells. RESULTS: Pomalidomide has an inhibitory effect on MM1.S cells with time-and dose-dependent manners. Pomalidomide induced apoptosis in MM1.S cells. When the concentration of pomalidomide was 0, 40 and 80 μmol/L, the expression of CRBN gene after the treatment of MM1.S cells for 72 hours was 1.487±0.340, 0.211±0.054 and 0.055±0.005, by using actin as internal refereme. Pomalidomide significantly reduced CRBN protein expression in MM1.S cells. CONCLUSION Pomalidomide can inhibit the proliferation of MM1.S cells and promote its apoptosis. A certain concentration of pomalidomide can reduce the expression of CRBN gene and down-regulate its protein expression in MM1.S cells.
Adaptor Proteins, Signal Transducing ; Apoptosis ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Multiple Myeloma ; Thalidomide ; analogs & derivatives

OBJECTIVE: To investigate the correlation of C-MYC protein with MDSC, Th17 cells and the pathogenesis of myeloma in different clinical stages. METHODS: A total of 65 patients with multiple myeloma treated in our hospital were selected as MM group, and 30 healthy subjects were selected as control group. The positive expression rate of C-MYC protein in bone marrow tissue, and the ratios of peripheral blood MDSC and Th17 cells were compared among the two groups, and the correlation of C-MYC protein, the ratio of MDSC, Th17 cells with onset of myeloma at different clinical stages, the relationship of the expression of C-MYC protein with the ratio of MDSC/Th17 cells and the clinical parameters of MM was analyzed. Also, the diagnostic value of single diagnosis and combined diagnosis was compared. RESULTS: The positive expression rate of C-MYC protein in bone marrow, the ratio of MDSC and Th17 cells in peripheral blood in MM group were significantly higher than those in normal control group(P＜0.05); the positive expression rate of C-MYC protein, MDSC and Th17 cells in patients at ISS stage Ⅰ, Ⅱ and Ⅲ MM showed an increasing trend (r=0.432, r=0.401, r=0.351); the correlation between the ratio of MDSC, Th17 cells and the positive expression rate of C-MYC protein in MM patients was positive (r=0.415, r=0.417); the area under ROC curve (AUC) of combined diagnosis was significantly larger than that of single index diagnosis (C-MYC protein, MDSC cells, Th17 cells)(P＜0.05). There was no correlation between the expression of C-MYC protein, the proportion of MDSC, Th17 cells and sex or age in MM patients (P＞0.05). CONCLUSION The positive expression rate of C-MYC protein and the proportion of MDSC and Th17 cells in MM patients significantly increase, which positively correlates with clinical ISS stagin.
Bone Marrow ; Humans ; Multiple Myeloma ; Proto-Oncogene Proteins c-myc ; Th17 Cells