王小燕 夏国光北京积水潭医院呼吸内科，北京 100035

    多发性骨髓瘤性胸腔积液3例

    王小燕夏国光▲

    北京积水潭医院呼吸内科，北京100035

    多发性骨髓瘤可出现髓外浸润，但累及胸膜腔出现骨髓瘤性胸腔积液罕见。本文回顾性分析北京积水潭医院2012年6月～2013年6月收治的3例骨髓瘤性胸腔积液患者的病例资料，其中有2例IgA型，出现于多发性骨髓瘤疾病进展期；1例为不分泌型，以胸腔积液为首发症状。前2例患者虽给予积极化疗但病情无好转，最后合并肺部感染而死亡，另外1例患者失访。回顾近10年文献报道，骨髓瘤性胸腔积液以IgG型为多见，其次为IgA型；可为单侧胸腔积液，亦可累及双侧；胸腔积液多出现于多发性骨髓瘤疾病进展期，部分患者以胸腔积液为首发症状。这类患者化疗效果不佳，预后差，生存时间一般不超过1年。

    骨髓瘤性胸腔积液；多发性骨髓瘤；浆细胞瘤；髓外浸润

    [Abstract]Multiple myeloma can appear marrow infiltration，but rare involving the pleural cavity，appear myeloma pleural effusion.This article retrospectively reviews the medical records of 3 patients diagnosed with myelomatous pleural effusion from June 2012 to June 2013 in Beijing Jishuitan Hospital.2 patients of our cases are IgA subtype and showed clinical aggressive characteristics.Chemotherapy turned out useless，and the 2 patients are death for pulmonary infection.1 patient has no secretory type，pleural effusion is the first symptom，and loss to follow-up.Recent decade literature reviews show myeloma pleural effusion dominance of IgG and IgA subtypes.Pleural fluid exist in single thorax or bilateral.Pleural effusion appear in progressive stage of myeloma disease ......