Dhingra KK, Singhal N, Nigam S, Jain S. Unsuspected multiples myeloma presenting as bilateral pleural effusion - a cytological diagnosis.
Cytojournal 2007;
4:17. [PMID:
17825100 PMCID:
PMC2000906 DOI:
10.1186/1742-6413-4-17]
[Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2007] [Accepted: 09/07/2007] [Indexed: 11/25/2022] Open
Abstract
Background
Multiple Myeloma presenting as a pleural effusion is extremely rare. It is usually a late complication and is associated with a poor prognosis.
Case Presentation
A 40-year-old male presented with dyspnea and fever of six months duration. Clinical diagnosis of pulmonary tuberculosis was considered. X-ray chest showed bilateral pleural effusion. Pleural cytology revealed numerous plasma cells, some of which were binucleated and atypical. Cytological differential diagnosis included: Myelomatous effusion and Non-Hodgkin's Lymphoma deposit (Immunoblastic type). Bone marrow biopsy, serum protein electrophoresis and bone scan confirmed the diagnosis of multiple myeloma (Plasmablastic type).
Conclusion
Myelomatous pleural effusion as an initial presentation although extremely rare, should always be considered in presence of atypical plasma cells irrespective of age.
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