Saidane Olfa, Slouma Maroua, Haouet Slim, Abdelmoula Leila
Charles Nicolle Hospital, Tunis, Tunisia.
Department of Rheumatology, University of Tunis El Manar, Tunis, Tunisia.
BMJ Case Rep. 2015 Oct 5;2015:bcr2015211197. doi: 10.1136/bcr-2015-211197.
Multiple myeloma (MM) is a malignant proliferation of a single clone of plasma cells and an excess of monoclonal immunoglobulin production. It is rarely associated with cutaneous and pleural involvement. We report a new case of a 62-year-old woman with a history of a symptomatic MM. Three months after chemotherapy initiation, she presented with subcutaneous nodules. Ultrasound-guided needle biopsy confirmed the diagnosis of cutaneous plasmacytomas. She underwent local radiation therapy leading to complete regression of subcutaneous nodules. One month later, she developed dyspnoea. Thoracic CT scan showed pleural thickening associated with pleural effusion. Pleural biopsy confirmed the diagnosis of pleural plasmacytoma. Chemotherapy including vincristine, doxorubicin and dexamethasone was administered. Cutaneous involvement and pleural effusion accompanying MM are uncommon. They are associated with poor prognosis.
多发性骨髓瘤（MM）是单个浆细胞克隆的恶性增殖，并产生过量的单克隆免疫球蛋白。它很少与皮肤和胸膜受累相关。我们报告了一例新病例，一名62岁女性，有症状性MM病史。化疗开始三个月后，她出现皮下结节。超声引导下针吸活检确诊为皮肤浆细胞瘤。她接受了局部放射治疗，皮下结节完全消退。一个月后，她出现呼吸困难。胸部CT扫描显示胸膜增厚并伴有胸腔积液。胸膜活检确诊为胸膜浆细胞瘤。给予了包括长春新碱、阿霉素和地塞米松的化疗。MM伴发的皮肤受累和胸腔积液并不常见。它们与预后不良相关。
