Multiple myeloma presenting as eosinophilic pleural effusion

Abstract

An elderly man, with no comorbidity, presented with rapidly accumulating left pleural effusion. He also had generalized adenopathy. Pleural fluid cytology showed exudative pleural effusion with eosinophilia. Supraclavicular lymph node biopsy was reported as amyloid. On further investigation he was found to have kappa-light chain multiple myeloma. The final diagnosis was eosinophilic pleural effusion in a patient with multiple myeloma.

A Breathless Dilemma: Myelomatous Pleural Effusion

“…True myelomatous pleural effusions (MPE) are very uncommon, with fewer than 100 cases reported in literature [6][7][8][9][10][11][12]. The diagnosis is usually confirmed by cytologic identification of malignant plasma cells and high levels of a monoclonal protein in the pleural fluid and histological study of pleural biopsy [13,14] At the time of diagnosis of MPE, patients also frequently have elevated serum β2-microglobulin, anemia, elevated serum lactate dehydrogenase, and elevated creatinine levels.…”