Myeloma multiplex with pulmonary dissemination

Area of Science:

• Hematology
• Oncology
• Pulmonology

Background:

• Multiple myeloma is a plasma cell malignancy primarily affecting the bone marrow.
• Extramedullary involvement, particularly in the lung parenchyma, is an uncommon manifestation.

Observation:

• A 79-year-old patient presented with fever, a right lung mass, and worsening renal failure requiring hemodialysis.
• Initial symptoms included oliguria, fever, and hemoptysis, treated with antibiotics and thoracocentesis for pleural effusion.

Findings:

• Diagnosis of multiple myeloma was established via myelogram following thoracocentesis.
• The patient's presentation included signs suggestive of disseminated disease beyond the bone marrow.

Implications:

• This case underscores the need to consider extramedullary multiple myeloma in elderly patients with end-stage renal disease and respiratory symptoms.
• Early recognition of lung plasmacytoma in multiple myeloma is crucial for appropriate management.