Bartlett R P, Greipp P R, Tefferi A, Cupps R E, Mullan B P, Trastek V F
Department of Internal Medicine, Mayo Clinic Rochester, MN 55905, USA.
Mayo Clin Proc. 1995 Dec;70(12):1161-4. doi: 10.4065/70.12.1161.
The occurrence of extramedullary hematopoiesis in the pleura is rare and is usually asymptomatic. It is generally diagnosed on postmortem examination. Herein we describe a 61-year-old woman with agnogenic myeloid metaplasia who sought medical assessment because of progressive dyspnea. Thoracentesis yielded sanguineous fluid with 10% myeloblasts. A 99mTc bone marrow scan demonstrated increased tracer activity throughout both lungs, an outcome consistent with extramedullary hematopoiesis. Fine-needle aspiration and video-assisted thoracoscopy were considered but deferred because of the potential risk of profuse bleeding. Treatment with low-dose external beam irradiation to the left posterior pleura was successful. To date, no hemothorax has recurred.
胸膜髓外造血的发生较为罕见，通常无症状。一般在尸检时诊断。在此，我们描述一名61岁患原发性骨髓化生的女性，她因进行性呼吸困难寻求医疗评估。胸腔穿刺抽出含10%成髓细胞的血性液体。锝-99m骨髓扫描显示双肺放射性示踪剂活性增加，这一结果与髓外造血相符。考虑过细针穿刺抽吸和电视辅助胸腔镜检查，但因有大出血的潜在风险而推迟。对左后胸膜进行低剂量体外照射治疗成功。迄今为止，未再发生血胸。
