Matýsková M, Krahulcová E, Buliková A, Novotná H
Oddĕlení klinické hematologie FN, Brno-Bohunice.
Vnitr Lek. 1995 Jul;41(7):467-9.
Multiple myeloma affects predominantly osseous spaces and the close vicinity of bones. A plasmacellular exudate is rare. The authors describe the course of plasmacellular leukaemia in a 68-year-old female patient where the first symptom of the disease was anaemia and a dextrolateral pleural exudate with a cytological finding of plasma cells. The exudate disappeared after the first cycle of chemotherapy and intrapleural administration of cytostatic. After the third cycle of chemotherapy remission of the disease was recorded which was, however, short. After three months' remission (six months after establishment of the diagnosis) the disease exacerbated violently, the dextrolateral exudate reappeared and gradually the insufficiency of the infiltrated bone marrow increased. The patient died one month after the relapse of the disease. The finding of a plasmacellular exudate must be considered the sign of a very poor prognosis and in that case very aggressive treatment is indicated.
多发性骨髓瘤主要累及骨腔及骨骼附近区域。浆细胞性渗出物较为罕见。作者描述了一名68岁女性患者的浆细胞白血病病程,该病的首发症状为贫血及右侧胸腔积液,胸腔积液细胞学检查发现浆细胞。化疗及胸腔内给予细胞抑制剂的第一个周期后,胸腔积液消失。化疗第三个周期后记录到疾病缓解,但缓解期较短。缓解三个月后(确诊六个月后)疾病剧烈恶化,右侧胸腔积液再次出现,浸润性骨髓功能不全逐渐加重。疾病复发一个月后患者死亡。发现浆细胞性渗出物必须被视为预后极差的征象,在这种情况下,应采取非常积极的治疗措施。