[Pulmonary and chest wall involvement in multiple myeloma]

Area of Science:

• Oncology
• Pulmonology
• Radiology

Background:

• Multiple myeloma (MM) presents diverse clinical manifestations, including bone disease and extramedullary plasmacytoma.
• Thoracic involvement in MM often involves bone or secondary pulmonary infections, complicating diagnosis in the elderly.
• The heterogeneous symptoms and severe clinical course of MM necessitate thorough investigation for accurate diagnosis.

Purpose of the Study:

• To investigate the causes, frequency, and prognostic impact of pulmonary involvement in multiple myeloma patients.
• To analyze the diagnostic challenges and radiographic variability of thoracic manifestations in MM.

Main Methods:

• Retrospective analysis of 38 multiple myeloma patients treated between January 1995 and April 2001.
• Evaluation of thoracic involvement, including pulmonary infiltrates and bone invasion, based on clinical and radiological findings.
• Histopathological confirmation of malignant plasma cell infiltration via lung biopsies in select cases.

Main Results:

• Fifty percent of patients (19/38) exhibited thoracic involvement, with 35% (13/38) showing pulmonary involvement.
• Pulmonary involvement presented as pneumonia, mass lesions, nodular lesions, or interstitial infiltration.
• Pulmonary involvement correlated with progressive disease, including renal failure and pathological bone fractures.

Conclusions:

• Pulmonary involvement in multiple myeloma is associated with rapid disease progression and diverse radiographic findings.
• MM should be considered in the differential diagnosis of pulmonary infiltrates in elderly patients with systemic complaints.
• Early recognition of pulmonary MM aids in timely management and improved patient outcomes.