MYELOMATÖZ PLEVRAL EFFÜZYON

Öz

Multipl myelomada malign myelomatöz plevral efüzyon görülmesi çok nadirdir. Özellikle hastal ığın başlangıcında saptanan malign myelomatöz efüzyon kötü prognostik faktördür ve agresif tedavi gerektirir. Elli dokuz yaşında kadın hasta sırtında sol supraskapular bölgede ağrı yakınması ile başvurdu. Toraks tomografisinde sol akciğer apikoposteriorda plevra tabanlı komşu kostalarda destrüksiyon oluşturan kitlesel lezyon, sol hemitoraksta plevral efüzyon, paravertebral alanda 10.torakal vertebranın sağ yarısında yumuşak doku artışı ve vertabral kortekste orta düzeyde düzensizlik gözlendi. Plevral sıvı ve kitle lezyonunun sitolojik örneklenmesinde Wright-Giemsa ile ekzantrik nülleuslu sitoplazmaları bazofilik boyanan plazma hücreleri görüldü. Protein elektroforezinde gama zincir oranı %30 olarak (momoklonal gamopati) saptandı. Olgu malign myelomatöz efüzyonun multipl myelom seyrinde nadir görülmesi nedeniyle sunuldu.

Anahtar Kelimeler

• Multipl myelom, miyelomatöz plevral efüzyon

MYELOMATOUS PLEURAL EFFUSION

Abstract

Malign p leural effusions due to myelomatous effusionis seen very rarely. Malign pleural effusion is a poor prognostic factor, and aggressive treatment should be considered, especially for patients with early-onset malign pleural effusion. 59 years old female patient was presented with complaint of pain on her left suprascapular area. On the thoracic computerized tomography, pleural-based tumor mass locating on the apico-posterior part of the left lung and causing destruction in adjacent ribs, pleural effusion on the left hemi-thorax, slight increase in soft tissues in the paravertebral region on the right half of 10th thoracic vertebra and mild irregularity in vertebral cortex were observed. Plasma cells with eccentric nuclei and basophilic stained cytoplasms were found in pleural fluid cytology and cytological examination of the biopsy samples with Wright-Giemsa dyes. In the protein electrophoresis, ratio of gamma-chain was 30% and monoclonal gammopathy was found. The case presented here was presented because of rarity of malign myelomatous pleural effusion in the course of multiple myeloma.

Keywords

• Multiple myeloma, myelomatous pleural effusion

Kaynakça

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