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Waldenström macroglobulinemia presenting as bilateral bloody pleural effusion: A case report
Tiantian Cen1, Qiaoli Zhang1, Yanan Ying1
1Department of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China.
Rationale:
Pleural effusion, especially bilateral bloody pleural effusion, is a rare complication of Waldenström macroglobulinemia (WM). Pleural effusion in patients with WM has many causes, such as infection, tumor invasion of the pleura, and rupture of the thoracic duct or its branches. Patients with WM presenting to the respiratory department with chest tightness and shortness of breath need more differential diagnosis by respiratory physicians, which is helpful for effective treatment. Herein, we present a case of MV diagnosis in a patient with bilateral bloody pleural effusion.
Patient Concern:
Our patient is a 59-year-old man with WM presenting as having bilateral bloody pleural effusion.
Interventions:
The patient was treated with pleural effusion drainage. After confirming the diagnosis, the patient was treated with rituximab, cyclophosphamide, and dexamethasone.
Outcomes:
Following these treatments, the patient's symptoms improved, and ultrasound showed a decrease in pleural effusion.
Lessons:
Despite its favorable prognosis, the cause of pleural effusion in a patient with WM can be challenging to diagnose. The cause of pleural effusion should be considered a differential diagnosis when diagnosing patients diagnosed with WM.
Insights
Bilateral bloody pleural effusion is a rare complication of Waldenström macroglobulinemia (WM). Prompt diagnosis and treatment with chemotherapy, including rituximab, cyclophosphamide, and dexamethasone, improved patient outcomes.
Area of Science:
- Hematology
- Oncology
- Pulmonology
Background:
- Waldenström macroglobulinemia (WM) can rarely present with bilateral bloody pleural effusion.
- Differential diagnosis for pleural effusion in WM patients is crucial for effective treatment.
- Causes include infection, tumor invasion, and thoracic duct rupture.
Observation:
- A 59-year-old male patient with WM presented with bilateral bloody pleural effusion.
- Symptoms included chest tightness and shortness of breath.
Findings:
- Pleural effusion drainage was performed.
- Diagnosis was confirmed, followed by treatment with rituximab, cyclophosphamide, and dexamethasone.
- The patient showed symptom improvement and reduced pleural effusion on ultrasound.
Implications:
- Pleural effusion should be considered in the differential diagnosis of WM patients.
- Timely diagnosis and appropriate treatment lead to favorable outcomes.
- This case highlights the importance of a multidisciplinary approach in managing rare WM complications.
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