Multiple myeloma presenting as eosinophilic pleural effusion.
Asmita A Mehta1, Rajesh Venkatakrishnan, Wesley Jose
1Department of Pulmonary Medicine, Amrita Institute of Medical Sciences, Kochi, Kerala, India. asmitamehta@aims.amrita.edu
Asia-Pacific Journal of Clinical Oncology
|December 1, 2010
Summary
A rare case of eosinophilic pleural effusion, characterized by excess eosinophils in the pleural fluid, was diagnosed in an elderly patient with multiple myeloma. This finding highlights an unusual presentation of this plasma cell disorder.
Area of Science:
- Hematology
- Oncology
- Pulmonology
Background:
- Multiple myeloma is a plasma cell malignancy primarily affecting the bone marrow.
- Pleural effusions are a known complication of multiple myeloma, but eosinophilic effusions are exceptionally rare.
Observation:
- An elderly male patient with no prior comorbidities presented with a rapidly accumulating left-sided pleural effusion and generalized lymphadenopathy.
- Initial pleural fluid analysis revealed an exudative effusion with significant eosinophilia.
- A supraclavicular lymph node biopsy indicated amyloid deposition.
Findings:
- Further investigations confirmed the patient had kappa-light chain multiple myeloma.
- The constellation of symptoms and biopsy results led to the final diagnosis of eosinophilic pleural effusion secondary to multiple myeloma.
Implications:
- This case underscores the importance of considering rare presentations of multiple myeloma.
- The presence of eosinophilic pleural effusion may warrant a thorough hematological workup for underlying plasma cell dyscrasias.
- Further research is needed to elucidate the mechanisms linking multiple myeloma and eosinophilic pleural effusions.
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