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相關文獻
- Recurrent Pleural Effusion in a Patient with Multiple Myeloma: A Case Report
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題名 | Recurrent Pleural Effusion in a Patient with Multiple Myeloma: A Case Report=多發性骨髓瘤併反覆肋膜積液--病例報告 |
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作 者 | 寸敏英; 林佑俊; 彭忠衎; | 書刊名 | 胸腔醫學 |
卷期 | 26:4 2011.08[民100.08] |
頁次 | 頁214-218 |
分類號 | 416.66 |
關鍵詞 | 多發性骨髓瘤; 反覆肋膜積液; 惡性胸水; Multiple myeloma; Myelomatous pleural effusion; Recurrent pleural effusion; |
語文 | 英文(English) |
中文摘要 | 有個85歲的女性病人,因長期下背痛至骨科門診求診及服用口服止痛劑。但未獲得改善,並建議住院做詳細檢查。脊椎核磁共振攝影發現有多處壓破性骨折及疑似骨轉移的病兆,並接受外科手術。病理組織確定為多發性骨髓瘤,同時胸部X光也診斷出右側肋膜積液尚未發現不正常細胞。不幸過了四個月,病人因呼吸急促再次入院,發現同側肋膜積液。同時發現漿細胞也證實了多發性骨髓瘤合併惡性胸水。多發性骨髓瘤合併惡性胸水並不多見。目前英文文獻中約90例,從未提報多發性骨髓瘤併反覆肋膜積液案例。 |
英文摘要 | Multiple myeloma (MM) is a malignant clonal neoplasm of plasma cells of B-lymphocyte origin. It can present with symptoms related to intramedullary involvement, such as low back pain or spinal compression fractures, or symptoms related to extramedullary involvement of the nasal cavity, lung, pleura, thoracic wall, central nervous system, lymph nodes, liver, spleen, skin, and eyes. Patients with MM may present with a pleural effusion, or pleural effusion may develop during the disease course; however, myelomatous pleural effusion is rare. We herein present a patient with IgG lambda light chain type MM who presented with a right-side pleural effusion with an absence of monoclonal plasma cells on cytological examination of the effusion. The patient received 2 courses of chemotherapy and the effusion resolved; however, 4 months later, it recurred and myelomatous pleural effusion was confirmed by the demonstration of monoclonal protein and atypical plasma cells in the pleural fluid. |
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