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一个罕见的同时发生的尿胸部和骨髓瘤性肺溢出的罕见病例
Prachi Bhanvadia1, Aarish Lalani1, Sara Samadami1
1Department of Internal Medicine, Ascension Saint Agnes Hospital, Baltimore, Maryland, USA.
Case reports in pulmonology
|March 13, 2026
概括
本病例报告详细介绍了多发性骨髓瘤患者的第一个同时发生骨髓瘤性多发性骨髓喷液 (MPE) 和尿胸的实例. 这种罕见的同时发生突显了复杂的肺溢病例需要进行彻底诊断的必要性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 在瘤学瘤学.
- 肺部病理学 肺部病理学
背景情况:
- 骨髓瘤性流 (MPE) 是多发性骨髓瘤 (<1%的病例) 的罕见并发症,预后不佳.
- 尿道胸部,由尿泄漏到腔空间引起,也是不常见的,通常与阻塞性泌尿病或创伤有关.
- 之前没有记录过MPE和尿胸的同时发生.
研究的目的:
- 报告第一个同时发生骨髓瘤性多叶膜溢出和尿胸的病例.
- 强调重叠的临床特征所带来的诊断挑战.
- 突出多学科方法在管理复杂的多流的重要性.
主要方法:
- 一个81岁的男性患有复发性多发性骨髓瘤的案例介绍.
- 诊断工作包括成像 (揭示水缩,阻塞性泌尿病,双侧流),胸腔切除,细胞学,免疫组织化学和盆腔质量活检.
- 治疗干预包括双边瘤切除.
主要成果:
- 这位患者出现呼吸不良,出血症和急性功能衰竭.
- 最初的发现表明尿胸,但尽管有瘤切除术,喷液却再次出现.
- 细胞学,免疫组织化学和活检证实了外骨髓瘤导致尿路阻塞的二次性骨髓瘤性肺溢液.
结论:
- 这是第一个报告的同时出现MPE和尿胸的病例.
- 这一案例强调了对复杂的多流的综合,多学科诊断策略的必要性.
- 准确的诊断对于适当的管理和改善患者结果至关重要.
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