Polski Alexander G, Ramirez Marquez Jerome, McQuiston Samuel
Radiology, USA Health University Hospital, Mobile, USA.
Cureus. 2023 Aug 6;15(8):e43040. doi: 10.7759/cureus.43040. eCollection 2023 Aug.
Multiple myeloma (MM) is a relatively common malignancy that primarily affects the bone marrow, while extramedullary disease (EMD) occurs in the skin and muscle, lung pleura, lymph nodes, liver, and CNS. Myelomatous pleural effusion (MPE) is a rare extramedullary manifestation of MM in which pleural fluid is composed almost entirely of abnormal plasma cells. MPE and other types of EMD are associated with poor prognosis, and MPE can present emergently due to tension physiology. We report a case of a patient with massive MPE presenting with contralateral midline shift. There are exceedingly few such cases and this report highlights a unique presentation of this rare clinical entity. Epidemiology, radiographic features, diagnosis, treatment, and implications for the prognosis of the disease are discussed.
多发性骨髓瘤（MM）是一种相对常见的恶性肿瘤，主要影响骨髓，而髓外疾病（EMD）则发生于皮肤、肌肉、肺胸膜、淋巴结、肝脏和中枢神经系统。骨髓瘤性胸腔积液（MPE）是MM一种罕见的髓外表现，其中胸水几乎完全由异常浆细胞组成。MPE和其他类型的EMD与预后不良相关，且MPE可因张力生理学而紧急出现。我们报告1例大量MPE患者出现对侧中线移位的病例。此类病例极少，本报告突出了这种罕见临床实体的独特表现。文中讨论了该疾病的流行病学、影像学特征、诊断、治疗及对预后的影响。
