흉벽과 복부림프절의 형질세포종과 늑막삼출이 동반된 다발성 골수종 1례

Abstract

Here, we present a case of multiple myeloma with plasmacytomas of chest wall and abdominal lymph nodes and bloody pleural effusion. A 60-year-old man complained of general weakness. Chesr CT scanning showed multiple bony destructive lesions at right 7, 8, 9th ribs with enhanced soft tissue densities and large amount of fluid collection in right pleural space. Abdominal CT scanning showed multiple variable sized isodense nodular mass with enhancement at perihepatic, left retrocrural and left adrenal areas with contracted both kidneys. Bone scintigraphy showed hot spots in left 1, 3, 6th and right 7, 8, 9th ribs, lower thoracic and lumbar spines. Serum protein electrophoresis revealed mild monoclonal gammopathy of lambda type, but the urine contained no monoclonal gammopathy. Iliac bone marrow aspiration and biopsy revealed infiltration of 56% of immature plasma cells. Biopsy of chest wall mass showed diffuse proliferation of myeloma cells of lambda light chain type. After 6 cycle of VAD combination chemotherapy, intraabdominal plasmacytomas were disappeared.