左前胸壁肿物合并胸腔积液的多发性骨髓瘤一例并文献复习

 目的　分析以胸壁肿物合并胸腔积液为首发症状的多发性骨髓瘤（MM）患者肺部浸润的临床病理特征。方法　分析1例MM肺部浸润患者的全部临床资料,同时复习相关文献。结果　根据临床症状、体征、各项理化和影像学检查及胸壁肿物细针穿刺的病理学特征,明确诊断为MM（IgG型 ,ISS分期Ⅲ期）。结论　胸壁肿物合并大量胸腔积液为首发表现的MM非常少见,在临床上极易被误诊,全面观察病情及各项检查结果对诊断及临床治疗有重要意义。     

多发性骨髓瘤伴恶性胸腔积液一例并文献复习

 【摘要】　目的　分析骨髓瘤性恶性胸腔积液的病因、诊断、治疗及预后。方法　回顾性分析1例伴有恶性胸腔积液的多发性骨髓瘤（MM）患者的临床资料并复习相关文献。结果　本例患者在骨髓瘤病程中出现恶性胸腔积液,通过胸腔积液脱落细胞学检查确诊,予硼替佐米+地塞米松治疗后疗效短暂,出现胸腔积液后仅生存5个月。结论　MM伴发恶性胸腔积液罕见,诊断主要依赖胸腔积液脱落细胞学检查,预后差,早期使用硼替佐米+地塞米松方案可能延长患者生存期。     

多发性骨髓瘤中枢神经系统浸润一例并文献复习

  目的　探讨多发性骨髓瘤（MM）中枢神经系统（CNS）浸润的诊治及预后。方法　报道1例CNS浸润的MM病例,并对其发生率、临床特点、诊断、治疗及预后等进行文献复习。结果　MM发生CNS浸润罕见,累及部位以脑膜最常见,临床表现缺乏特异性,脑脊液检查、病理活组织检查及影像学检查有助于明确诊断。一旦发生无有效治疗手段。结论　累及CNS的MM发病率低,预后不良。     

多发性骨髓瘤合并胸腔积液25例临床分析

目的 提高对多发性骨髓瘤(MM)合并胸腔积液诊治的认识.方法 回顾性分析2005年1月至2015年1月收治的25例MM合并胸腔积液患者的临床特征、实验室指标、胸腔积液检查结果,总结其临床特点并进行文献复习.结果 25例合并胸腔积液的MM患者中IgG型占多数(10例);低蛋白血症12例,肾功能不全13例,肺部感染19例,同时有三种并发症7例;细胞遗传学异常者7例,胸膜受累者2例.可评估疗效者12例,其中达比较满意的部分缓解2例,部分缓解1例,稳定2例,进展5例,治疗过程中死亡2例,总有效率为19.99%.结论 MM患者合并胸腔积液的发生与肾功能异常、感染、低蛋白血症、胸膜浸润等因素有关,且此类患者多存在高龄、高肿瘤负荷、细胞遗传学异常等不良预后因素,总体治疗效果差,生存率低.     

多发性骨髓瘤合并胸腔积液的临床观察

 目的　探讨多发性骨髓瘤（MM）合并胸腔积液的临床特点、预后及治疗方法。方法　2005年6月至2010年3月共收治162例MM患者,其中15例合并胸腔积液,男8例,女7例,中位年龄56.8（37～68）岁。所有患者胸腔积液的诊断依靠体格检查、胸部X线检查、胸腔积液脱落细胞学检查。按照国际分期系统（ISS）及Durie-Salmon分期系统进行分期。结果　15例患者中13例胸腔积液脱落细胞学检查找到骨髓瘤细胞,另有2例反复胸腔积液找脱落细胞均阴性。对以上患者采用含有硼替佐米、大剂量糖皮质激素及顺铂、环磷酰胺、依托泊苷、泼尼松的DECP方案进行治疗,胸腔积液虽有一定控制,但均很快复发。11例患者死亡,2例目前疾病尚稳定,2例失访。结论　MM合并胸腔积液的患者治疗效果差,骨髓瘤性胸腔积液被认为是疾病终末期或预示疾病急剧进展的表现。     

多发性骨髓瘤中枢神经系统浸润二例并文献复习

目的探讨多发性骨髓瘤（MM）中枢神经系统（CNS）浸润的诊断、治疗方法。方法报告2例伴有CNS浸润的MM,并对该病的临床表现、实验室检查、诊断及治疗进行文献复习。结果CNS发病率低,常常通过血行播散而累及软脑膜,或由邻近的骨质破坏浸润而来,具有与其他软脑膜恶性肿瘤相似的症状和体征。影像学检查、脑脊液及病理活组织检查有助于明确诊断。可进行局部鞘内注射,局部放疗及全身化疗,但治疗效果不理想。结论发生CNS浸润的MM发病率低,预后不良。     

多发性骨髓瘤双侧乳腺浸润1例

多发性骨髓瘤（multiple myeloma,MM）是浆细胞异常增生恶性肿瘤,是一种进行性的肿瘤性疾病,其特征为骨髓浆细胞瘤和一株完整性的单克隆免疫球蛋白（IgG,IgA,IgD或IgE）或Bence Jones蛋白质（游离的单克隆性κ或γ轻链）过度增生。     

多发性骨髓瘤伴脾脏浸润一例并文献复习

目的：观察多发性骨髓瘤（MM）伴脾脏浸润患者的临床特点及治疗反应。方法对1例脾脏浆细胞瘤患者的临床资料进行分析并复习相关文献。结果该患者起病初无脾脏大,通过影像学和病理检查明确诊断,应用含硼替佐米方案治疗2个疗程,达部分缓解（PR）。由于未继续巩固治疗,6个月后随访提示病情进展。结论含硼替佐米方案对 MM 伴脾脏浸润的患者有良好的治疗效果,需要扩大病例进一步研究。     

以腹腔积液为首发症状的多发性骨髓瘤1例报告及文献复习

目的观察治疗以腹腔积液为首发症状的多发性骨髓瘤的临床及实验室特征。方法临床诊断1例患者，给予治疗并文献复习。结果患者腹腔积液中找到瘤细胞，腹腔积液中存在M蛋白。结论以腹腔积液为首发症状的多发性骨髓瘤发生率极低，预后差，生存时间短，VAB方案对该病仍有效，加强支持治疗有望改善疾病预后．     

Simultaneous multiple myeloma and non-small cell lung carcinoma: A case report and review of the literature

Multiple myeloma (MM) is the second commonest hematologic malignancy. Synchronous presentation of MM and lung cancer is a rare occurrence. The present study reports a case of MM combined with lung cancer and reviews previously reported cases of the co-existence of non-small cell lung carcinoma and MM. At Hebei General Hospital (Shijiazhuang, China), a 52-year-man was diagnosed with MM complicated by lung lesion. Lung computed tomography (CT) showed an increase in lesion density after the second cycle of chemotherapy. The lesion was surgically removed and the patient was diagnosed with non-small cell lung carcinoma by lung biopsy pathology. After the fifth cycle of VDT (bortezomib, dexamethasone and thalidomide), the patient received autologous stem cell transplantation. Immunohistochemical staining for CD38, CD138, CD39, CD203a and TNF-α were positive in both MM and lung cancer; CD73 was only positive in lung cancer. The present study described the rare event of the simultaneous occurrence of MM and lung adenocarcinoma and discussed the potential link between the two tumors. CD38 may play a role in MM and lung cancer by changing the bone marrow microenvironment through adenosine.     

例IgD多发性骨髓瘤患者多柔比星脂质体化疗后胸腔积液消退

IgD myelomas account for only 2% of all myelomas. This kind of hematological malignancy is severe and carries a bleak prognosis. Pleural effusion is very rare in multiple myeloma. We reported a case in which pleural effusion appeared at the end of the illness of IgD myeloma and treated with liposomal doxorubicin.     

多原发癌临床特征分析

目的：探讨多原发癌的病因、临床特点、治疗及预后。方法：对1997年1月-2007年12月收治的50例多原发癌患者的临床资料进行回顾性分析。结果：10年中共收治恶性肿瘤患者3650例,其中多原发癌50例,占1.36%。发病年龄48岁-74岁,平均65.2岁。50例多原发癌中有46例为二重癌,4例为三重癌。同时性发生者10例,异时性发生者40例,间隔时间10-108个月,平均28.2个月。首发癌和二重癌均以消化系统最常见,其次是泌尿生殖系统和呼吸系统。外科手术及放化疗后3年生存率50%,5年生存率22%。结论：多原发癌的病因可能与遗传因素、放疗、化疗等有关。如果能够早期诊断、正确及时的治疗,可取得较好疗效。     

多原发癌临床特征分析

目的:探讨多原发癌的病因、临床特点、治疗及预后。方法:对1997年1月-2007年12月收治的50例多原发癌患者的临床资料进行回顾性分析。结果:10年中共收治恶性肿瘤患者3650例,其中多原发癌50例,占1.36%。发病年龄48岁-74岁,平均65.2岁。50例多原发癌中有46例为二重癌,4例为三重癌。同时性发生者10例,异时性发生者40例,间隔时间10-108个月,平均28.2个月。首发癌和二重癌均以消化系统最常见,其次是泌尿生殖系统和呼吸系统。外科手术及放化疗后3年生存率50%,5年生存率22%。结论:多原发癌的病因可能与遗传因素、放疗、化疗等有关。如果能够早期诊断、正确及时的治疗,可取得较好疗效。     

Retreatment of a patient who presented with synchronous multiple primary colorectal carcinoma: report of a case

It is well known that one-stage resection of synchronous multiple primary colorectal carcinoma is an ideal choice if the patient’s physical condition is not bad. Detailed examination of the whole intestinal tract is very important for patients with colorectal cancer, which could prevent patients from receiving repeat treatment to a great extent. We present a case report of a patient with synchronous primary colorectal cancer. Because pre- or intra-operative examination is not sufficient at his first consultation, the patient had undergone multiple operations after receiving chemotherapy, radiotherapy and intestinal stent insertion, which results in peritoneal adhesions formation. The preoperative placement of prophylactic ureteral catheters facilitated recognition of ureters in operation that assure the prevention of ureteral injuries. If not aware of the importance of detailed preoperative examination and standardized treatment can lead to wrong treatment as in this case. Prophylactic ureteral catheters might assist in their immediate recognition.Key Words: Synchronous multiple primary colorectal carcinoma, repeat operation, prophylactic ureteral catheters     

肾及结肠多原发恶性肿瘤一例报告并文献复习

目的:探讨肾及结肠多原发恶性肿瘤的临床诊疗过程及其特征,以提高对该病的认识。方法:回顾性分析我院一例肾及结肠多原发恶性肿瘤患者的临床资料,并检索相关数据库,对相关文献进行系统性分析,归纳其临床特点。结果:本例患者手术后一般情况良好出院,随访六个月未见进展。结论:肾及结肠多原发恶性肿瘤在临床上较为罕见,早期可无特异性临床表现,多以影像学检查为主,临床上易与恶性肿瘤复发、转移混淆,确诊依靠病理诊断。发病机制和治疗方法存在争议,预后较差。     

Orbital multiple myeloma: Case report and review of computed tomography features

Orbital involvement at diagnosis in multiple myeloma is rare. Only a few a cases are reported with computed tomographic features. We report a case of orbital myeloma, and relevant medical reviews on computed tomography features are discussed.     

Multiple primary carcinoma of the lung

The risk of developing multiple primary lung carcinoma is rare (1.07%) but increases with time following resection of the first primary lesion. Eight well-documented cases are reported along with a review of 351 cases reported in the literature. The interval between metachronous lesions ranged from 9 months to 17 years. Surgical resection remains the preferred treatment of resectable nonsmall cell carcinoma, with 5 year survival of 11%. All patients with lung carcinoma should be followed-up for the rest of their lives because of the possible occurrence of a second primary.     

同时性多原发癌伴肝转移1例并文献复习

目的 探讨同时性多发性骨髓瘤和结肠癌的病因、诊断及治疗方法.方法 对1例同时诊断为多发性骨髓瘤和结肠癌并继发肝转移患者的临床资料及相关文献进行回顾性分析.结果 患者以贫血为首发症状,骨髓穿刺术提示多发性骨髓瘤,荧光原位杂交检测示14q32 IgH基因重排阳性,肠镜及病理活检明确诊断结肠癌,数月后继发肝占位.给予VTD方...