Multiple Myeloma with Myelomatous Pleural Effusion: A Case Report and Review of the Literature

Kim, Yu Jin; Kim, Su Jin; Min, Kwangseon; Kim, Ho Young; Kim, Hyo Jung; Lee, Young Kyung; Zang, Dae Young

doi:10.1159/000165694

Cited by 39 publications

(36 citation statements)

References 51 publications

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“…As MPE is usually a late manifestation in the natural history of MM or an expression of an aggressive disease, previous reports have identified MPE as a poor prognostic factor [4,15,16,17]. Similarly in our series, though small in number, those with myelomatous effusion had significantly shorter OS compared to those without ( p = 0.002; Fig.…”

Section: Discussionsupporting

confidence: 63%

“…Pleural effusion (PE) is not an uncommon finding in multiple myeloma (MM) and up to 11% of MM patients develop PE of various etiologies during their disease course [1,2,3,4,5]. Common causes of PE associated with MM are heart failure secondary to amyloidosis, renal failure, and parapneumonic effusion.…”

Section: Introductionmentioning

confidence: 99%

“…Common causes of PE associated with MM are heart failure secondary to amyloidosis, renal failure, and parapneumonic effusion. Although uncommon, since myelomatous PE (MPE) development has prognostic implications [3,4], timely intervention is warranted for establishing adaptive treatment strategies. Unfortunately, considering that the median age at MM diagnosis is over 70 years [6,7], deciding which of these frail patients should undergo invasive procedures as opposed to empirical treatment when PE occurs remains obscure.…”

Section: Introductionmentioning

confidence: 99%

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Pleural Effusion in Multiple Myeloma: Characteristics and Practice Patterns

et al. 2017

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In many Asian countries battling with the double burden of increasing noninfectious diseases on top of infectious diseases, multiple myeloma (MM) patients presenting with pleural effusion (PE) pose a great diagnostic challenge. Thus, we aimed to analyze the clinical features and practice patterns of such patients. This is a multicenter retrospective study of newly diagnosed MM patients between January 2011 and December 2015. Among 575 MM patients diagnosed during the study period, 80 (13.9%) that were associated with PE were identified and analyzed. The most common cause of PE was parapneumonic (25%), followed by reactive (18.8%). Higher CRP levels and leukocytosis were indicators of parapneumonic PE. There were 7 (8.8%) with myelomatous PE and 2 (2.5%) with tuberculosis. Fifty-six patients underwent additional examinations to determine the exact cause of effusion; 28 patients received computed tomography (CT) of the chest, 5 patients underwent thoracentesis/biopsy, and 23 patients underwent both CT and thoracentesis/biopsy. On the other hand, 24 patients did not undergo additional analyses but were treated empirically. Real-world analyses of practice patterns in MM patients with PE showed the suboptimal use of invasive procedures to determine the exact cause of PE. Since reversible causes and tuberculosis pleurisy are not uncommon, invasive procedures should be actively incorporated as needed.

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Section: Discussionsupporting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pleural Effusion in Multiple Myeloma: Characteristics and Practice Patterns

et al. 2017

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“…However, other case studies suggest that majority of MPE take place in patients with the most abundant, IgG myeloma. Case reviews also show that MPE occurs equally among both genders, is typically hemorrhagic and occurs more commonly on the left [15][16][17].…”

Section: Discussionmentioning

confidence: 96%

A Breathless Dilemma: Myelomatous Pleural Effusion

Thiruchelvam¹,

Onyshchenko²

2015

J Clin Respir Dis Care

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“…[1,2] Although plasma cells are widely distributed throughout the body, PCM is found most often within the bone and bone marrow (BM), while the dissemination of extramedullary plasmacytoma into the lung has been reported to be very rare. [3] MM establishes 27% of all biopsied bone tumors, and 1% of all malignancies.…”

Section: Discussionmentioning

confidence: 99%

Multiple myeloma mimicking metastatic lung cancer

Furuncuoglu¹,

Cirak²,

Türk³

et al. 2015

TJ Oncol

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Multiple myeloma is a hematological malignancy characterized by a clonal proliferation of plasma cells in the bone marrow. Extramedullary dissemination of multiple myeloma is uncommon. Only in rare cases, the malignant plasma cells of multiple myeloma had infiltrated the lung parenchyma. In this case report, we presented a case of multiple myeloma with lung plasmacytoma, in a 42-year-old patient, hospitalized for pain and infiltrative mass in the right lung. The results of his initial evaluation with computed tomography and positron emission tomograpy scanning, resembled lung tumor with bone metastasis. Surprisingly, biopsies from lung tumor and bone metastasis, revealed malignant plasma cells. We found M spike in protein electrophoresis and lambda monoclonal band in immune electrophoresis. A bone marrow biopsy evaluation was done and justified multiple myeloma diagnosis before hematology referral. Multiple myeloma diagnosis at the age of 42 is quite rare.Keywords: Cancer; lung; metastasis; myeloma.Multipl miyelom kemik iliğinde plasma hücrelerinin klonal proliferasyonu ile karekterize hematolojik malign bir hastalıktır. Multipl miyelomda ekstramedüller yayılım sık değildir. Çok nadir olgularda multipl miyelom nedenli plazma hücrele-ri akciğer parankimini infiltre eder. Bu yazıda, sağ akciğerde infiltratif kitle ve ağrı nedeniyle hastaneye yatırılan, akciğer plasmasitomlu multipl miyelomu olan 42 yaşında bir hasta sunuldu. Bilgisayarlı tomografi ve pozitron emisyon tomografisi ile yapılan ilk değerlendirmede kemik metastası olan akciğer tümörüne benzetildi. Akciğerdeki tümörden ve kemikteki metastastan yapılan biyopside sürpriz olarak malign plazma hücreleri görüldü. Protein elektroforezinde M spike ve immün elektroforezde monoklonal lamda bandı bulundu. Kemik iliği biyopsisi yapıldı ve multipl miyelom tanısı konarak hematolojiye refere edildi. Multipl miyelom 42 yaşında nadir görülür.

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Multiple Myeloma with Myelomatous Pleural Effusion: A Case Report and Review of the Literature

Cited by 39 publications

References 51 publications

Pleural Effusion in Multiple Myeloma: Characteristics and Practice Patterns

Pleural Effusion in Multiple Myeloma: Characteristics and Practice Patterns

A Breathless Dilemma: Myelomatous Pleural Effusion

Multiple myeloma mimicking metastatic lung cancer

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