Myelomatous pleural effusion and extensive extraskeletal soft tissue involvement: a rare presentation of clonal plasma cell disorders. Issue 9 (12th September 2019)

• Record Type: Journal Article
• Authors: Alexander, Vijay; Binu, Aditya John; Sathyendra, Sowmya
• Is Part Of: BMJ case reports. Volume 12:Issue 9(2019)
• Publication Date: 2019-09-12
• Subjects: haematology (drugs and medicines) -- respiratory system; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2019-230560
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : A 65-year-old woman presented with a history of progressive dyspnoea, left pleuritic pain, loss of weight and appetite. Previous history was significant for pulmonary tuberculosis diagnosed 10 years before. Physical examination revealed a left supraclavicular soft tissue mass with absent breath sounds over the left hemithorax. Investigations revealed hypercalcemia with albumin:globulin reversal. The bone marrow biopsy was consistent with the diagnosis of multiple myeloma (IgG). Pleural fluid analysis revealed an exudative effusion; cytology showed mature plasma cells and plasmablasts. Serum electrophoresis revealed an M band in the gamma region. Biopsy of the supraclavicular mass revealed plasma cells which were CD 138+ with Kappa light chain restriction. She was initiated on chemotherapy and is currently doing well. Myelomatous pleural effusion is a rare presentation of multiple myeloma.