Kappa Light-Chain Multiple Myeloma with Myelomatous Pleural Effusion a Case Report and Review of the Literature

臨床上造成肋膜積水的原因有許多，例如：心臟衰竭、腎病症候群、肝硬化及腫瘤等。在多發性骨髓瘤者，肋膜積水中出現多發性骨髓瘤細胞，非常少見，此時對於化學治療的效果及預後皆不佳。報告一位kappa輕鏈多發性骨髓瘤合併肋膜積水的病例，經由骨髓病理切片及肋膜積水細胞的免疫化學染色檢查，均發現kappa輕鏈多發性骨髓瘤細胞，並討論有關多發性骨髓瘤肋膜積水的細胞學診斷及影響預後的因素。The occurrence of myelomatous pleural effusion in patients with multiple myeloma is extremely rare. Here we report a case of kappa light-chain multiple myeloma with myelomatous pleural effusion, which was confirmed by Wright-Geimsa stain and immunocytochemical studies of sediments of pleural effusion. The related literature about the cytologic diagnosis and the prognostic factors of myelomatous pleural effusion are also reviewed.