以胸腔积液为首要表现的多发性骨髓瘤一例_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

吴桢珍 ¹ , 李姗 ¹ , 王艳丽 ¹ , 马淑颖 ² , 黄茂 ¹ ,  赵欣 ¹

1. ;
2. ;

Corresponding author：

赵欣, Email: xinzhao1104@163.com

Keywords：

多发性骨髓瘤; 胸腔积液; 内科胸腔镜

DOI：

10.7507/1671-6205.202203005

Video：

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目的分析多发性骨髓瘤合并胸膜转移患者的临床特征。方法回顾性分析1例多发性骨髓瘤合并胸腔积液患者的临床资料、实验室检查、影像学检查、病理学结果及预后，并复习相关文献。结果患者为52岁女性，经血常规、生化常规、血清肿瘤标志物及胸腔穿刺行积液常规、生化、肿瘤标志物及细胞学等检查，发现患者中度贫血、肿瘤标志物神经元特异性烯醇化酶显著升高，胸腔积液沉渣见大量浆细胞。经局部麻醉内科胸腔镜胸膜活检，镜下见胸膜肥厚，血管扩张、紊乱，部分结节样增生。后组织病理诊断为浆细胞瘤，结合后续尿蛋白电泳等检查，确诊为多发性骨髓瘤。经化疗及自体干细胞移植术等治疗，患者于13个月后因疾病复发死亡。多发性骨髓瘤出现胸膜浸润的患者较为罕见，多为预后不良的标志，神经元特异性烯醇化酶升高也可作为其预后相关指标。对于疑难胸膜疾病，创伤性相对较小的内科胸腔镜手术可作为诊断的重要手段。结论合并胸腔积液的多发性骨髓瘤患者临床特征不典型，需重视胸腔积液细胞学检查并及时获取组织病理。

Citation： 吴桢珍, 李姗, 王艳丽, 马淑颖, 黄茂, 赵欣. 以胸腔积液为首要表现的多发性骨髓瘤一例. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(5): 356-359. doi: 10.7507/1671-6205.202203005 Copy

1.	Kintzer JS Jr, Rosenow EC 3rd, Kyle RA. Thoracic and pulmonary abnormalities in multiple myeloma. A review of 958 cases. Arch Intern Med, 1978, 138(5): 727-730.
2.	Alexandrakis MG, Passam FH, Kyriakou DS, et al. Pleural effusions in hematologic malignancies. Chest, 2004, 125(4): 1546–1555.
3.	Wang Z, Xia GG, Lan L, et al. Pleural effusion in multiple myeloma. Intern Med, 2016, 55(4): 339-345.
4.	Byun JM, Kim KH, Choi IS, et al. Pleural effusion in multiple myeloma: characteristics and practice patterns. Acta Haematol, 2017, 138(2): 69-76.
5.	Chen H, Li PF, Xie Y, et al. Cytology and clinical features of myelomatous pleural effusion: three case reports and a review of the literature. Diagn Cytopathol, 2018, 46(7): 604-609.
6.	中国医师协会血液科医师分会, 中华医学会血液学分会. 中国多发性骨髓瘤诊治指南(2022年修订). 中华内科杂志, 2022, 61(5): 480-487.
7.	Bhatnagar R, Maskell N. The modern diagnosis and management of pleural effusions. BMJ, 2015, 351: h4520.
8.	Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin, 2019, 69(1): 7-34.
9.	高盼, 何文杰, 孙英丽, 等. 小细胞肺癌的CT表现分类及其价值. 放射学实践, 2018, 33(8): 847-851.
10.	张忆梓, 侯健, 韦苇, 等. 血清神经元烯醇化酶活性对初发多发性骨髓瘤患者预后的影响. 中华血液学杂志, 2012, 33(5): 417-419.
11.	Yang HP, Mi RH, Wang Q, et al. Expression of neuron-specific enolase in multiple myeloma and implications for clinical diagnosis and treatment. PLoS One, 2014, 9(5): e94304.
12.	Bae JY, Kim Y, Kang HJ, et al. Imaging features of various benign and malignant tumors and tumorlike conditions of the pleura: a pictorial review. Taehan Yongsang Uihakhoe Chi, 2020, 81(5): 1109-1120.
13.	Bibby AC, Maskell NA. Pleural biopsies in undiagnosed pleural effusions; Abrams vs image-guided vs thoracoscopic biopsies. Curr Opin Pulm Med, 2016, 22(4): 392-398.
14.	Dixon G, de Fonseka D, Maskell N. Pleural controversies: image guided biopsy vs. thoracoscopy for undiagnosed pleural effusions? J Thorac Dis, 2015, 7(6): 1041-1051.

1. Kintzer JS Jr, Rosenow EC 3rd, Kyle RA. Thoracic and pulmonary abnormalities in multiple myeloma. A review of 958 cases. Arch Intern Med, 1978, 138(5): 727-730.
2. Alexandrakis MG, Passam FH, Kyriakou DS, et al. Pleural effusions in hematologic malignancies. Chest, 2004, 125(4): 1546–1555.
3. Wang Z, Xia GG, Lan L, et al. Pleural effusion in multiple myeloma. Intern Med, 2016, 55(4): 339-345.
4. Byun JM, Kim KH, Choi IS, et al. Pleural effusion in multiple myeloma: characteristics and practice patterns. Acta Haematol, 2017, 138(2): 69-76.
5. Chen H, Li PF, Xie Y, et al. Cytology and clinical features of myelomatous pleural effusion: three case reports and a review of the literature. Diagn Cytopathol, 2018, 46(7): 604-609.
6. 中国医师协会血液科医师分会, 中华医学会血液学分会. 中国多发性骨髓瘤诊治指南(2022年修订). 中华内科杂志, 2022, 61(5): 480-487.
7. Bhatnagar R, Maskell N. The modern diagnosis and management of pleural effusions. BMJ, 2015, 351: h4520.
8. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin, 2019, 69(1): 7-34.
9. 高盼, 何文杰, 孙英丽, 等. 小细胞肺癌的CT表现分类及其价值. 放射学实践, 2018, 33(8): 847-851.
10. 张忆梓, 侯健, 韦苇, 等. 血清神经元烯醇化酶活性对初发多发性骨髓瘤患者预后的影响. 中华血液学杂志, 2012, 33(5): 417-419.
11. Yang HP, Mi RH, Wang Q, et al. Expression of neuron-specific enolase in multiple myeloma and implications for clinical diagnosis and treatment. PLoS One, 2014, 9(5): e94304.
12. Bae JY, Kim Y, Kang HJ, et al. Imaging features of various benign and malignant tumors and tumorlike conditions of the pleura: a pictorial review. Taehan Yongsang Uihakhoe Chi, 2020, 81(5): 1109-1120.
13. Bibby AC, Maskell NA. Pleural biopsies in undiagnosed pleural effusions; Abrams vs image-guided vs thoracoscopic biopsies. Curr Opin Pulm Med, 2016, 22(4): 392-398.
14. Dixon G, de Fonseka D, Maskell N. Pleural controversies: image guided biopsy vs. thoracoscopy for undiagnosed pleural effusions? J Thorac Dis, 2015, 7(6): 1041-1051.

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以胸腔积液为首要表现的多发性骨髓瘤一例

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