Bilateral pleural effusion as an initial manifestation of multiple myeloma: A case report and literature review

Jiang,Ai‑Gui; Yang,Yu‑Tian; Gao,Xiao‑Yan; Lu,Hui‑Yu

doi:10.3892/etm.2015.2184

March-2015 Volume 9 Issue 3

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

March-2015 Volume 9 Issue 3

Full Size Image

Case Report

Bilateral pleural effusion as an initial manifestation of multiple myeloma: A case report and literature review

Authors:
- Ai‑Gui Jiang
- Yu‑Tian Yang
- Xiao‑Yan Gao
- Hui‑Yu Lu
View Affiliations / Copyright

Affiliations: Department of Respiratory Medicine, Taizhou People's Hospital, Taizhou, Jiangsu 225300, P.R. China
Pages: 1040-1042
|
Published online on: January 15, 2015

https://doi.org/10.3892/etm.2015.2184
Expand metrics +

Abstract

Multiple myeloma (MM) is a rare type of malignant hematological neoplasm. Although primarily involving the bone marrow, MM has a significant risk of metastasizing to other organs and may present with various clinical symptoms. However, the involvement of the respiratory system in the course of MM is extremely uncommon, particularly presenting with bilateral pleural effusion as the sole initial manifestation, which may result in a delayed diagnosis of MM. The present study describes the extremely rare case of a patient with MM presenting with myelomatous pleural effusion (MPE). The 78‑year‑old patient was admitted to the Department of Respiratory Medicine, Taizhou People's Hospital (Taizhou, China) in March 2014, complaining of persistent dyspnea. Following admission, chest computed tomography scans revealed bilateral pleural effusion and a small amount of pericardial effusion, but no evident mass lesion. Thoracentesis was performed and the resulting pleural effusion was exudative and slightly bloody. In the following cytological examination, myeloma cells were identified in the pleural effusion. The patient was diagnosed definitively with MM following a histopathological study of the bone marrow aspiration. Therefore, the observations of the present case report may promote the consideration of MM in the differential diagnosis of patients with unexplained and refractory pleural effusion. The present study also reviewed the literature with regard to the association between MM and pleural effusion.

View Figures

View References

1	Elloumi M, Frikha M, Masmoudi H, et al: Plasmocytic pleural effusion disclosing multiple myeloma. Rev Mal Respir. 17:495–497. 2000.(In French). PubMed/NCBI
2	Cho YU, Chi HS, Park CJ, Jang S, Seo EJ and Suh C: Myelomatous pleural effusion: a case series in a single institution and literature review. Korean J Lab Med. 31:225–230. 2011. View Article : Google Scholar : PubMed/NCBI
3	Xu XL, Shen YH, Shen Q and Zhou JY: A case of bilateral pleural effusion as the first sign of multiple myeloma. Eur J Med Res. 18:72013. View Article : Google Scholar : PubMed/NCBI
4	Singhal S, Mehta J, Desikan R, et al: Antitumor activity of thalidomide in refractory multiple myeloma. N Engl J Med. 341:1565–1571. 1999. View Article : Google Scholar : PubMed/NCBI
5	Richardson PG, Blood E, Mitsiades CS, et al: A randomized phase 2 study of lenalidomide therapy for patients with relapsed or relapsed and refractory multiple myeloma. Blood. 108:3458–3464. 2006. View Article : Google Scholar : PubMed/NCBI
6	Kamble R, Wilson CS, Fassas A, et al: Malignant pleural effusion of multiple myeloma: prognostic factors and outcome. Leuk Lymphoma. 46:1137–1142. 2005. View Article : Google Scholar : PubMed/NCBI
7	Kyle RA and Rajkumar SV: Multiple myeloma. Blood. 111:2962–2972. 2008. View Article : Google Scholar : PubMed/NCBI
8	Kyle RA and Rajkumar SV: Multiple myeloma. N Engl J Med. 351:1860–1873. 2004. View Article : Google Scholar : PubMed/NCBI
9	Lin M, Zhu J, Shen H and Huang J: Gastrointestinal bleeding as an initial symptom in asymptomatic multiple myeloma: A case report and review of the literature. Oncol Lett. 5:218–220. 2013.
10	Kapadia SB: Multiple myeloma: a clinicopathologic study of 62 consecutively autopsied cases. Medicine (Baltimore). 59:380–392. 1980. View Article : Google Scholar
11	Kintzer JS Jr, Rosenow EC III and Kyle RA: Thoracic and pulmonary abnormalities in multiple myeloma: A review of 958 cases. Arch Intern Med. 138:727–730. 1978. View Article : Google Scholar : PubMed/NCBI
12	Alexandrakis MG, Passam FH, Kyriakou DS and Bouros D: Pleural effusions in hematologic malignancies. Chest. 125:1546–1555. 2004. View Article : Google Scholar : PubMed/NCBI
13	International Myeloma Working Group. Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group. Br J Haematol. 121:749–757. 2003. View Article : Google Scholar : PubMed/NCBI
14	Oudart JB, Maquart FX, Semouma O, Lauer M, Arthuis-Demoulin P and Ramont L: Pleural effusion in a patient with multiple myeloma. Clin Chem. 58:672–674. 2012. View Article : Google Scholar : PubMed/NCBI
15	Wan YY, Lin DJ, Guo HS, Li XL, Yao ZH and Qiu YT: Multiple myeloma with pleural effusion as initial symptom: a report of one case and literature review. Guo Ji Hu Xi Za Zhi. 30:1097–1099. 2010.(In Chinese).
16	Buyukberber M, Sevinc A, Cagliyan CE, Gulsen MT, Sari I and Camci C: Non-Hodgkin lymphoma with high adenosine deaminase levels mimicking peritoneal tuberculosis: an unusual presentation. Leuk Lymphoma. 47:565–568. 2006. View Article : Google Scholar : PubMed/NCBI
17	Aghaei M, Karami-Tehrani F, Salami S and Atri M: Adenosine deaminase activity in the serum and malignant tumors of breast cancer: the assessment of isoenzyme ADA1 and ADA2 activities. Clin Biochem. 38:887–891. 2005. View Article : Google Scholar : PubMed/NCBI
18	Richardson PG, Sonneveld P, Schuster MW, et al; Assessment of Proteosome Inhibition for Extending Remissions (APEX) Investigators. Bortezomib or high-dose dexamethasone for relapsed multiple myeloma. N Engl J Med. 352:2487–2498. 2005. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Bilateral pleural effusion as an initial manifestation of multiple myeloma: A case report and literature review

This article is mentioned in:

Abstract

Figure 1

Figure 2

Figure 3

Related Articles