Bilateral Malignant Pleural Effusion in Multiple Myeloma-A Case Report and Literature Review

合併兩側惡性胸水的多發性骨髓瘤－病例報告與文獻探討

黃培銘(Pei-Ming Huang) ； 許超群(Chau-Chyun Sheu) ； 蔡慧珍(Hui-Jen Tsai) ； 黃琬婷(Wan-Ting Huang) ； 黃吉志(Jhi-Jhu Hwang) ； 黃明賢(Ming-Shyan Huang)

《胸腔醫學》 22卷4期 (2007/08) Pp. 279-285

https://doi.org/10.29806/TM.200708.0009

摘要

胸水在多發性骨髓瘤的病人身上並不常見。有很多原因會產生這個情況，而大部份是良性的。我們報告一個IgG-λ多發性骨髓瘤的病人合併兩側惡性胸水以及皮膚的侵犯。病人最初以左側大量惡性胸水表現，並在很短的時問內發展出右側惡性胸水。雖然她接受了積極的化學治療，但其病情仍快速惡化，並在被診斷出多發性骨髓瘤十週後死亡。我們的觀察與其他的報告一致：當多發性骨髓瘤病患出現惡性胸水時，代表這個腫瘤已經到了末期，且預後極差。因此，我們必須更了解惡性漿細胞的生物學以及其產生惡性胸水的致病機轉，以期能改善我們對這個併發症的處理方式以及這個疾病的預後。

關鍵字

多發性骨髓瘤 ； 惡性胸水

並列摘要

Pleural effusion is an uncommon manifestation of multiple myeloma. Several mechanisms have been proposed for the development of pleural effusion in multiple myeloma, and most of them are benign. We report a patient with IgG-λ multiple myeloma with bilateral malignant pleural effusions and cutaneous involvement. She initially presented with massive left-sided malignant pleural effusion, and shortly thereafter, she developed right-sided malignant pleural effusion. Even though aggressive chemotherapy was administered, she died 10 weeks after diagnosis. Our observation in this case was consistent with that of other reports, in that the presentation of malignant pleural effusion indicates an advanced stage and a very poor prognosis for patients with multiple myeloma. Further investigations on malignant plasma cell biology and the explicit mechanisms of malignant pleural effusion in multiple myeloma are needed in order to improve the management and outcome of this malignancy.

並列關鍵字

multiple myeloma ； malignant pleural effusion