Myelomatous Pleural Effusion: A Rare Involvement in Multiple Myeloma: Case Report

Abstract

998leural involvement in multiple myeloma is distinctly rare and accepted as an indicator of an unfavorable prognosis. [1][2][3] A high adenosine deaminase (ADA) level in the pleural fluid is especially frequent in pleural involvement due to tuberculosis and malignant and lymphoproliferative disease. 4 We present a case with myelomatous pleural effusion in which a significantly increased pleural fluid ADA level was detected. To our knowledge, this is the fourth case showing a high ADA activity in pleural effusion due to multiple myeloma. Myelomatous Pleural Effusion:A Rare Involvement in Multiple Myeloma:Case Report A AB BS S T TR RA AC CT T Mul tip le mye lo ma is a ne op las tic di sor der ca u sed by the pro li fe ra ti on of a sing le plasma cell clo ne and is as so ci a ted with the pro duc ti on of mo noc lo nal im mu nog lo bu lin. Mul tip le myelo ma ra rely in vol ves the ple u ra, and this in vol ve ment in di ca tes an un fa vo rab le prog no sis. We re port a 53-ye ar-old man with mul tip le mye lo ma and a mye lo ma to us right-si ded ple u ral ef fu si on with ele va ted ade no si ne de a mi na se (ADA) ac ti vity. The di ag no sis was ma de by exa mi na ti on of the ple ural flu id cyto logy and ple u ral bi opsy spe ci men. Syste mic che mot he rapy was ad mi nis te red to the pa ti ent, and ple u re de sis was per for med. Ho we ver, the pa ti ent di ed 3.5 months af ter the di ag no sis. In cre a sed ADA ac ti vity may be ob ser ved in mye lo ma to us ple u ral ef fu si on, and it may mi mic tu bercu lo us ple u ri tis.K Ke ey y W Wo or rd ds s: : Ple u ral ef fu si on; ade no si ne de a mi na se; mul tip le mye lo ma Ö ÖZ ZE ET T Mul tipl mi ye lo ma tek bir plaz ma hüc re klo nu nun pro li fe ras yo nu nun se bep ol du ğu, ne op lastik bir bo zuk luk tur ve mo nok lo nal im mü nog lo bu lin üre ti mi ile iliş ki li dir. Mul tipl mi ye lo ma na diren plev ra yı tu tar ve bu tu tu lum olum suz bir prog no za işa ret eder. Biz mul tipl mi ye lo ma sı ve art mış ade no zin de a mi naz (ADA) ak ti vi te si ile sağ ta raf lı mi ye lo ma töz plev ral efüz yo nu olan 53 ya şın da bir er kek has ta bil di ri yo ruz. Ta nı plev ral sı vı si to lo ji si ve plev ral bi yop si ör ne ği in ce le ne rek ko nuldu. Has ta ya sis te mik ke mo te ra pi ve ril di ve plö re dez ya pıl dı, an cak has ta ta nı dan 3.5 ay son ra öl dü. Mi ye lo ma töz plev ral efüz yon da ADA ak ti vi te sin de ar tış göz le ne bi lir ve bu du rum tü ber kü loz plö -ri ti tak lit ede bi lir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Plev ral ef füz yon; ade no zin de a mi naz; mul tipl mi ye lom T Tu ur rk ki iy ye e K Kl li in ni ik kl le er ri i J J M Me ed d S Sc ci i 2 20 01 11 1; ;3 31 1( (4 4) ): :9 99 98 8--1 10 00 01 1