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Primary malignant myelomatous pleural effusion.
Ankit Mangla1, Nikki Agarwal2, George J Kim3
1Division of Hematology / Oncology Department of Internal Medicine John H. Stroger Jr. Hospital of Cook County 1901 West Harrison Street Chicago Illinois 60612 USA.
Clinical Case Reports
|August 16, 2016
Summary
Primary malignant myelomatous pleural effusion (PMMPE) is rare in multiple myeloma patients. Identifying immature plasma cells in effusions indicates a poor prognosis and worse survival outcomes.
Area of Science:
- Hematology
- Oncology
- Pulmonology
Background:
- Multiple myeloma is a plasma cell malignancy.
- Pleural effusion is a rare complication of multiple myeloma.
Observation:
- Primary malignant myelomatous pleural effusion (PMMPE) occurs in less than 1% of multiple myeloma cases.
- Diagnosis relies on cytology or flow cytometry showing plasma cells.
Findings:
- Immature plasma cells, characterized by a high nucleus to cytoplasm ratio, visible nucleolus, Mott cells, and Russell bodies, are independent poor prognostic factors.
- PMMPE is associated with a significantly worse prognosis and poor overall survival compared to secondary pleural effusions.
Implications:
- Accurate differentiation of PMMPE from secondary pleural effusions is crucial for patient management.
- Recognizing PMMPE signals a need for intensified treatment strategies and palliative care discussions.
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