Bilateral Pleural Effusions due to Pulmonary Amyloidosis as the Presenting Manifestation of Multiple Myeloma

Agarwal, Abhishek; Singla, Sandeep; Bansal, Meghana; Nair, Bijay

doi:10.4084/mjhid.2012.010

Cited by 5 publications

(6 citation statements)

References 10 publications

(10 reference statements)

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“…Agarwall et al demonstrated that in their case; the pleural fluid cytology did not reveal any myelomatous cell, and the recurrent effusions were secondary to pulmonary amyloidosis. 16 In our case, plasmocytoma diagnosis was confirmed by biopsy from the mass on ribs, whereas pleural involvement of multiple myeloma was detected by using flow cytometry of pleural fluid.…”

Section: Discussionmentioning

confidence: 53%

Flow Cytometry Method as a Diagnostic Tool for Pleural Fluid Involvement in a Patient with Multiple Myeloma

Keklik

Şıvgın

Pala

et al. 2012

Mediterr J Hematol Infect Dis

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Multiple myeloma is a malignant proliferation of plasma cells that mainly affects bone marrow. Pleural effusions secondary to pleural myelomatous involvement have rarely been reported in the literature. As it is rarely detected, we aimed to report a case in which pleural effusion of a multiple myeloma was confirmed as true myelomatous involvement by flow cytometry method. A 52-years old man presented to our clinic with chest and back pain lasting for 3 months. On the chest radiography, pleural fluid was detected in left hemithorax. Pleural fluid flow cytometry was performed. In the flow cytometry, CD56, CD38 and CD138 found to be positive, while CD19 was negative. True myelomatous pleural effusions are very uncommon, with fewer than 100 cases reported worldwide. Flow cytometry is a potentially useful and simple method for detection of pleural fluid involvement in multiple myeloma.

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Section: Discussionmentioning

confidence: 53%

Flow Cytometry Method as a Diagnostic Tool for Pleural Fluid Involvement in a Patient with Multiple Myeloma

Keklik

Şıvgın

Pala

et al. 2012

Mediterr J Hematol Infect Dis

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“…A total of 95 articles published over a period of 63 years were included, representing a final sample of 196 patients with PA. Figure 1 shows the flow chart of the article selection process. [ 8 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 <...…”

Section: Resultsmentioning

confidence: 99%

Characteristics of pleural effusion due to amyloidosis

Ferreiro¹,

Pou²,

Suárez-Antelo³

et al. 2023

Ann Thorac Med

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The characteristics of patients with pleural amyloidosis (PA) are poorly known. A systematic review was performed of studies reporting clinical findings, pleural fluid (PF) characteristics, and the most effective treatment of PA. Case descriptions and retrospective studies were included. The review included 95 studies with a total sample of 196 patients. The mean age was 63 years, male/female ratio was 1.6:1, and 91.9% of patients were >50 years. The most common symptom was dyspnea (88 patients). PF was generally serious (63%), predominantly lymphocytic, and with the biochemical characteristics of transudates (43.4%) or exudates (42.6%). Pleural effusion was generally bilateral (55%) and <1/3 of the hemithorax (50%), although in 21% pleural effusion (PE) exceeded 2/3. Pleural biopsy was performed in 67 patients (yield: 83.6%; 56/67) and was positive in 54% of exudates and 62.5% of unilateral effusions. Of the 251 treatments prescribed, only 31 were effective (12.4%). The combination of chemotherapy and corticosteroids was effective in 29.6% of cases, whereas talc pleurodesis was effective in 21.4% and indwelling pleural catheter in 75% of patients (only four patients). PA is more frequent in adults from 50 years of age. PF is usually bilateral, serous, and indistinctly a transudate or exudate. A pleural biopsy can aid in diagnosis if effusion is unilateral or an exudate. Treatments are rarely effective and there may be definitive therapeutic options for PE in these patients.

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“…However, they can present with a variety of pulmonary symptoms that include, but not limited to, shortness of breath, wheezing, recurrent pneumonia, cough, hemoptysis and even pleural effusions. 5,6 For definitive diagnosis of amyloidosis, histologic evidence is required. Although often transbronchial biopsy is a safe and effective method for diagnosis, it is diagnostic in only approximately 60% of cases.…”

Section: Clinical Discussionmentioning

confidence: 99%

An Unusual Case of Chronic Hemoptysis

Chopra

Patel

Puthalapattu

et al. 2021

Chest

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A 62-year-old African American man was admitted to the hospital with hemoptysis. He had a complicated medical history significant for active tobacco use (>50 pack-year history), coronary artery disease, and heart failure with reduced ejection fraction. He reported intermittent episodes of coughing up streaks of blood in the sputum for the past 3 years. For the past few days before this presentation, he had multiple episodes of coughing up over a tablespoon of only blood. He was not on any anticoagulant agents. There were no risk factors for TB, nor was there a history of fevers, chills, shortness of breath, leg swelling, changes in his urine color and frequency or urgency, or unintended weight loss. On admission, he was noted to be breathing comfortably. Vital signs revealed a temperature of 36.6 o C, BP of 138/70 mm Hg, heart rate of 66 beats/min, respiratory of rate of 18 breaths/ min, and a blood oxygen saturation level of 98% on room air. Physical examination was significant for decreased bilateral breath sounds with no wheezing, crackles, or rhonchi. Cardiovascular examination revealed normal cardiac rhythm without murmur, rubs, or gallops. There was no clubbing or edema on his extremities.

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Bilateral Pleural Effusions due to Pulmonary Amyloidosis as the Presenting Manifestation of Multiple Myeloma

Cited by 5 publications

References 10 publications

Flow Cytometry Method as a Diagnostic Tool for Pleural Fluid Involvement in a Patient with Multiple Myeloma

Flow Cytometry Method as a Diagnostic Tool for Pleural Fluid Involvement in a Patient with Multiple Myeloma

Characteristics of pleural effusion due to amyloidosis

An Unusual Case of Chronic Hemoptysis

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