Multipli mijelom sa pulmonalnom diseminacijom

  • Brankica Terzić Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
  • Djoko Maksić Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Vesna Škuletić Insitute of Pathology, Military Medical Academy, Belgrade, Serbia
  • Dejan Pilčević Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
  • Mirjana Mijušković Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
  • Zoran Čukić Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
  • Katarina Obrenčević Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
  • Marijana Petrović Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
  • Jelena Tadić - Pilčević Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
  • Milica Petrović Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
DOI: https://doi.org/10.2298/1809
Ključne reči: multiple myeloma||, ||multipli mijelom, neoplasm metastasis||, ||neoplazme, diseminacija, lung||, ||pluća, plasma cells||, ||plazma ćelije,

Sažetak



Uvod. Multipli mijelom je hematološko maligno oboljenje koje se odlikuje klonalnom proliferacijom plazma ćelija u koštanu srž. Ekstramedularna diseminacija multiplog mijeloma izuzetno je retka. U samo nekoliko slučajeva opisana je diseminacija multiplog mijeloma u pluća. Prikaz bolesnika. Prikazali smo bolesnika sa multiplim mijelomom plućne lokalizacije, starog 79 godina, koji je hospitalizovan zbog febrilnosti i infiltrativne promene u desnom pluću. Dva meseca pre prijema, zbog razvoja terminalne bubrežne slabosti, započeto je lečenje hemodijalizom, tri puta nedeljno. Od tog perioda bolesnik je bio oliguričan, a zbog pojave febrilnosti i hemoptizija lečen je najpre dvojnom antibiotskom terapijom, na čiju primenu je došlo do prolaznog poboljšanja opšteg stanja, ali bez povlačenja pleuranog izliva. Nakon učinjene torakocenteze, a potom i mijelograma, postavljena je dijagnoza multiplog mijeloma. Zaključak. Kod bolesnika srednjeg i starijeg životnog doba uz opštu slabost, malaksalost, gubitak telesne mase, bubrežnu insuficijenciju koja brzo progredira do terminalne, ukoliko se pojave simptomi u respiratornom traktu, diferencijalno dijagnostički treba razmišljati i o ekstramedularnoj, plućnoj diseminaciji multiplog mijeloma.

Biografija autora

Brankica Terzić, Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
Nefrologija

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Objavljeno
2015/04/23
Broj časopisa
Vol. 71 Br. 6 (2014)
Rubrika
Prikaz bolesnika