演題詳細

ポスター / Poster

ポスター 35 (Poster 35) :骨髄腫:症例(レナリドミド)

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日程
2013年10月11日(金)
時間
16:50 - 17:50
会場
ポスター会場 / Poster (ロイトン札幌 3F ロイトンホールABCD)
座長・司会
和泉 透 (Tohru Izumi):1
1:栃木県立がんセンター 血液内科
 
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Extramedullary plasmacytoma manifested as pleural effusion treated with low-dose lenalidomide

演題番号 : PS-1-261

吉村 英晃 (Hideaki Yoshimura):1、藤田 真也 (Shinya Fujita):1、堀田 雅章 (Masaaki Hotta):1、佐竹 敦志 (Atsushi Satake):1、石井 一慶 (Kazuyoshi Ishii):1、伊藤 量基 (Tomoki Ito):1、野村 昌作 (Shosaku Nomura):1

1:1st Dept. Int. Med., Kansai Medical Univ., Osaka, Japan

 

We report here on a case of an 82-year-old man. He visited a general hospital due to low grade fever, cough and exertional dyspnea. Chest X-ray showed massive bilateral pleural effusion, but no abnormal findings were detected on FDG-PET-CT. CD38 highly-expressed cells were detected by the pleural fluid examination. Then he was referred to our hospital. Laboratory data were as follows; TP7.0g/dl, Alb3.1g/dl, IgG1770mg/dl, IgA375mg/dl, IgM54mg/dl, B2MG3.7mg/l. The slight elevation of serum monoclonal IgG-kappa was detected by immunofixation. Bone marrow aspiration did not reveal a proliferation of atypical plasma cells, and the clonality of plasma cells on FCM was not detected either. Thus, this patient was diagnosed as extramedullary plasmacytoma. He was treated with dexamethasone pulse therapy. However, pleural effusion did not reduce at all. Therefore, we administered low-dose lenalidomide(10mg daily on day 1-21) and dexamethasone because of his age and renal dysfunction. After 1 course of Ld therapy, he developed skin rush on lower abdomen, right inguinal and femoral region, and CRP elevated to 17.1mg/dl. Since the reduction in pleural effusion was observed on chest X-ray, we continued Ld therapy with reduction in dose of lenalidomide to 5mg daily. Thereafter, the skin rush disappeared gradually, and we confirmed that the quantity of pleural effusion was reducing. To the best of our knowledge, this is a rare case of extramedullary plasmacytoma manifested as pleural effusion without bone marrow region, and treated successfully using low-dose lenalidomide.

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