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[Pleural effusion revealing multiple myeloma].

D Belhabib1, S Maalej, S Hantous

  • 1Service Ibn Nafis, Hôpital de Pneumo-Phtisiologie Abderrahman-Mami, 2080 L'Ariana/Tunis, Tunisie. Dalenda.chtourou@rns.tn

Revue De Pneumologie Clinique
|November 18, 2005
PubMed
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Pleural effusion is a rare sign of multiple myeloma, occurring in only 1% of cases. This report details two instances where pleural effusion was the initial indicator of this plasma cell cancer.

Area of Science:

  • Hematology
  • Oncology
  • Pulmonology

Background:

  • Multiple myeloma, a plasma cell malignancy, rarely presents with pleural effusion.
  • Myelomatous pleural effusion is an infrequent manifestation, estimated in only 1% of multiple myeloma cases.
  • Pleural effusion as the initial presenting symptom of multiple myeloma is exceptionally rare.

Observation:

  • Two cases of multiple myeloma (IgA and IgG) are presented, both initially diagnosed via pleural effusion.
  • The first case involved a 61-year-old female with widespread myeloma (bone, endobronchial, pericardial) and effusion.
  • The second case involved a 65-year-old male with isolated pleural effusion as the sole presenting sign.

Findings:

  • Pleural effusions in both cases were confirmed as myelomatous in origin.

Related Experiment Videos

  • Diagnostic confirmation was achieved by identifying identical monoclonal immunoglobulins in both serum and pleural fluid.
  • Atypical plasma cells were identified within the pleural fluid cytology.

    • Implications:

    • These cases highlight that pleural effusion, though rare, can be the primary manifestation of multiple myeloma.
    • The diagnostic confirmation through immunoglobulin analysis and cytology is crucial for identifying myelomatous effusions.
    • Increased awareness among clinicians may improve early diagnosis of multiple myeloma presenting with this rare sign.