Şebnem YOSUNKAYA, Raziye YAZICI, Emin MADEN, Faruk ÖZER, Hatice TOY, İsmail REİSLİ

Bilateral plevral tutulum ile başvuran multipl miyelom olgusu

Multipl miyelomda plevral efüzyon nispeten nadir bir bulgudur; miyelomatöz tutuluma bağlı malign plevral efüzyon ise çok daha nadir görülür. Biz bilateral miyelomatöz plevral efüzyonu olan bir olgu sunduk. Miyelomatöz etyoloji plevral sıvı protein elektroforezinde gammopatinin gösterilmesi ve plevral sıvı sitolojisinde bol miktarda atipik plazma hücrelerinin gösterilmesiyle kondu. Multipl miyeloma bağlı plevral sıvılar genellikle IgA tipi multipl miyelomlarda görülmektedir. Sunulan olgunun plevral sıvının akım sitometrik çalışmasında CD-138 pozitif hücre yüzeylerinde IgG olduğu gösterildi. Daha önce multipl miyelom tanısı almamış olan bir hastanın plevra tutulumu ile başvurabileceği, tutulumun bilateral olabileceği, tanıda akım sitometrinin kullanılabileceği vurgulandı.

A multiple myeloma case presenting with bilateral pleural involvement

Pleural effusion is a relatively infrequent finding in multiple myeloma (MM) and malign effusions due to myelomatous effusion is seen very rarely. In this article we reported a case with bilateral myelomatous effusion. Myelomatous etiology was detected by demonstrating gammopaty in pleural fluid protein electrophoresis and demonstrating abundant number of atypical plasma cells in pleural fluid cytology. Pleural fluids due to MM are usually seen in IgA type of MM’s, IgG on the surface of CD-138 positive cell was demonstrated in flow cytometric study of the pleural fluid of the reported case. In conclusion we mentioned that a patient who does not have diagnosis of MM before may present with pleural involvement, the involvement may be bilateral and flow cytometry can be used in diagnosis.

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