Göðüs Hastanesi Dergisi. 2010; 24(2): 119-123

MYELOMATÖZ PLEVRAL EFFÜZYON

Sibel AYIK¹, Aydan MERTOÐLU¹, Ayþe ÖZSÖZ¹, Ercan ÇÝL¹, Zekiye AYDOÐDU DÝNǹ
Dr. Suat Seren Göðüs Hastalýklarý ve Cerrahisi Eðitim ve Araþtýrma Hastanesi, Göðüs Hastalýklarý, Ýzmir

Multipl myelomada malign myelomatöz plevral efüzyon görülmesi çok nadirdir. Özellikle hastalýðýn baþlangýcýnda saptanan malign myelomatöz efüzyon kötü prognostik faktördür ve agresif tedavi gerektirir. Elli dokuz yaþýnda kadýn hasta sýrtýnda sol supraskapular bölgede aðrý yakýnmasý ile baþvurdu. Toraks tomografisinde sol akciðer apikoposteriorda plevra tabanlý komþu kostalarda destrüksiyon oluþturan kitlesel lezyon, sol hemitoraksta plevral efüzyon, paravertebral alanda 10.torakal vertebranýn sað yarýsýnda yumuþak doku artýþý ve vertabral kortekste orta düzeyde düzensizlik gözlendi. Plevral sývý ve kitle lezyonunun sitolojik örneklenmesinde Wright-Giemsa ile ekzantrik nülleuslu sitoplazmalarý bazofilik boyanan plazma hücreleri görüldü. Protein elektroforezinde gama zincir oraný %30 olarak (momoklonal gamopati) saptandý. Olgu malign myelomatöz efüzyonun multipl myelom seyrinde nadir görülmesi nedeniyle sunuldu.

Anahtar Kelimeler: Multipl myelom, miyelomatöz plevral efüzyon

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MYELOMATOUS PLEURAL EFFUSION

Sibel AYIK¹, Aydan MERTOÐLU¹, Ayþe ÖZSÖZ¹, Ercan ÇÝL¹, Zekiye AYDOÐDU DÝNǹ
Dr. Suat Seren Göðüs Hastalýklarý ve Cerrahisi Eðitim ve Araþtýrma Hastanesi, Göðüs Hastalýklarý, Ýzmir

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

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