Bilateral pleural effusion as an initial manifestation of multiple myeloma: A case report and literature review

March 2015
Experimental & Therapeutic Medicine;2015, Vol. 9 Issue 3, p1040
Academic Journal
Multiple myeloma (MM) is a rare type of malignant hematological neoplasm. Although primarily involving the bone marrow, MM has a significant risk of metastasizing to other organs and may present with various clinical symptoms. However, the involvement of the respiratory system in the course of MM is extremely uncommon, particularly presenting with bilateral pleural effusion as the sole initial manifestation, which may result in a delayed diagnosis of MM. The present study describes the extremely rare case of a patient with MM presenting with myelomatous pleural effusion (MPE). The 78-year-old patient was admitted to the Department of Respiratory Medicine, Taizhou People's Hospital (Taizhou, China) in March 2014, complaining of persistent dyspnea. Following admission, chest computed tomography scans revealed bilateral pleural effusion and a small amount of pericardial effusion, but no evident mass lesion. Thoracentesis was performed and the resulting pleural effusion was exudative and slightly bloody. In the following cytological examination, myeloma cells were identified in the pleural effusion. The patient was diagnosed definitively with MM following a histopathological study of the bone marrow aspiration. Therefore, the observations of the present case report may promote the consideration of MM in the differential diagnosis of patients with unexplained and refractory pleural effusion. The present study also reviewed the literature with regard to the association between MM and pleural effusion.


Related Articles

  • Myelomatous pleural effusion - Thoracoscopic evaluation of a rare entity. Patil, Chetan B.; Gupta, Neeraj; Gupta, Rakesh C.; Dixit, Ramakant; Gupta, Ankur; Indushekar, Varna // Lung India;Sep/Oct2015, Vol. 32 Issue 5, p505 

    Multiple myeloma is a malignant neoplasm of plasma cell origin that mainly affects bone marrow and skeletal system, producing large amount of light chain immunoglobulins. Pleural involvement in multiple myeloma is a rare complication which carries very poor prognosis. We report a case of...

  • Multiple myeloma with pleural involvement. Liang Chen; Jia-Huan Wang; Wan-An Zhu; Jing Wang; Chun-Lai Dai; Yu-Xue Bai // Pakistan Journal of Medical Sciences;Mar2011, Vol. 27 Issue 2, p458 

    This study presents the differential diagnosis of metastatic tumors of the pleura vs. primary pleural malignancies in a male patient whose diagnosis was multiple myeloma with pleural involvement and confirmed by bone marrow aspiration and pleural biopsy. Computed tomography (CT) manifestations...

  • Pleur�sie my�lomateuse: � propos d�une observation. Jallouli, M.; Kaddour, N.; Kchaou, M.; Marzouk, S.; Frigui, M.; Boudawara, T.; Bahloul, Z. // Oncologie;Apr2008, Vol. 10 Issue 4, p279 

    Pleural effusions are relatively rare during the course of multiple myeloma and most often occur with non-specific disorders of the disease. We report an observation of myelomatous pleural effusion; the diagnostic was ascertained by the pleural biopsy. The patient did not respond to the therapy...

  • Pulmonary and nodal multiple myeloma with a pleural effusion mimicking bronchogenic carcinoma. Kushwaha, R. A. S.; Verma, Sanjay Kumar; Mehra, Sumit; Prasad, R. // Journal of Cancer Research & Therapeutics;Oct-Dec2009, Vol. 5 Issue 4, p297 

    Multiple myeloma (MM) is a hematological malignancy characterized by the occurrence of plasma cell tumor within the bone marrow. Extramedullary plasmacytomas form a small percentage of plasma cell tumors, and although 80-90% of extramedullary lesions occur in the head and neck, pulmonary...

  • Focal segmental glomerulosclerosis, secondary amyloidosis and multiple myeloma. Ashrafi, Farzaneh; Mortazavi, Mojgan; Manouchehri, Navid; Moghaddam, Noushin Afshar; Nasri, Hamid; Sarrami, Amir Hossein // Pakistan Journal of Medical Sciences;Apr2012, Vol. 28 Issue 2, p345 

    Focal segmental glomerulosclerosis (FSGS) is a kind of glomerulonephritis characterized by scar tissue that forms in parts of the kidney called glomeruli. Association of FSGS with hematologic malignancies such as plasma cell disorder is an uncommon condition. We report a 58-yearold male with...

  • Serum Growth Differentiation Factor 15 Levels in Newly Diagnosed Multiple Myeloma Patients. Tarkun, Pinar; Birtas atesoglu, Elif; Mehtap, Ozgur; Musul, Mahmut Mert; Hacihanefioglu, abdullah // Acta Haematologica;Mar2014, Vol. 131 Issue 3, p173 

    Background/Aims: Multiple myeloma (MM) is a hematological cancer associated with increased clonal malignant plasma cells. Growth differentiation factor 15 (GDF 15) is a protein that is highly expressed in the bone marrow mesenchymal stem cells of patients with MM. This study investigated whether...

  • Growth Differentiation Factor 15 in Multiple Myeloma: A Microenvironment Factor Predictive of Response to Treatment? Corre, Jill // Acta Haematologica;Mar2014, Vol. 131 Issue 3, p170 

    No abstract available

  • A Rare Case of Multple Myeloma (Mm) Presented With Pancytopaenia in A Patient of HIV - At Very Early Age. KUMAR PATRA, SISIR; SOREN, MANOJ; KUMAR DAS, ANJAN; MANGAL, SRISHTIDHAR // Journal of Clinical & Diagnostic Research;Jan2015, Vol. 9 Issue 1, p7 

    Non-hodgkin's lymphoma (NHL) is the most common haematological malignancy which is seen in HIV infected patients. Among NHLs, immunoblastic lymphomas are most common and a majority of these are diffuse large B-cell lymphomas. Multiple myeloma is a disease of the elderly. It is extremely rare...

  • Myelomatous Pleural Effusion Presenting with Extreme Hyperferritinemia and Severe Inflammatory Response. adrianzen Herrera, Diego a.; Scott, Matthew; Varma, Mala // Case Reports in Oncology;May-Aug2015, Vol. 8 Issue 2, p349 

    Myelomatous involvement of pleural effusions developing in patients with multiple myeloma is extremely rare and only a few cases have been reported so far. It is thought to represent an aggressive clinical progression of disease and is usually associated with severe complications, poor prognosis...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics