Recurrent Pleural Effusion in a Patient with Multiple Myeloma: A Case Report

Abstract

Multiple myeloma (MM) is a malignant clonal neoplasm of plasma cells of B-lymphocyte origin. It can present with symptoms related to intramedullary involvement, such as low back pain or spinal compression fractures, or symptoms related to extramedullary involvement of the nasal cavity, lung, pleura, thoracic wall, central nervous system, lymph nodes, liver, spleen, skin, and eyes. Patients with MM may present with a pleural effusion, or pleural effusion may develop during the disease course; however, myelomatous pleural effusion is rare. We herein present a patient with IgG lambda light chain type MM who presented with a right-side pleural effusion with an absence of monoclonal plasma cells on cytological examination of the effusion. The patient received 2 courses of chemotherapy and the effusion resolved; however, 4 months later, it recurred and myelomatous pleural effusion was confirmed by the demonstration of monoclonal protein and atypical plasma cells in the pleural fluid.