Pleural effusion and multiple myeloma ‑ more than meets the eye: A case report

Ramos,Ana Luísa; Trindade,Miguel; Pinto,André Santos; Brandão,José Ricardo; Pedrosa,Cláudia; Pinto,Alexandre

doi:10.3892/mco.2021.2401

Pleural effusion and multiple myeloma ‑ more than meets the eye: A case report

Authors:
- Ana Luísa Ramos
- Miguel Trindade
- André Santos Pinto
- José Ricardo Brandão
- Cláudia Pedrosa
- Alexandre Pinto
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Affiliations: Pulmonology Department, Egas Moniz Hospital, 1349‑019 Lisbon, Portugal, Medicine Department, Fernando Fonseca Hospital, 2720‑276 Amadora, Portugal, Medicine Department, West Hospital Center‑Torres Vedras, 2560‑324 Torres Vedras, Portugal, Department of Pathological Anatomy, University Hospital Center of Porto, 4099‑901 Porto, Portugal, Department of Clinical Hematology, University Hospital Center of Porto, 4099‑901 Porto, Portugal, Department of Intensive Care, University Hospital Center of Porto, 4099‑901 Porto, Portugal
Published online on: September 20, 2021 https://doi.org/10.3892/mco.2021.2401
Article Number: 238
Copyright: © Ramos et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Multiple myeloma (MM) accounts for 1% of all cancers. It consists of malignant proliferation of plasma cells, which is often associated with hypersecretion of a monoclonal protein. Pleural effusion (PE) in MM is not an uncommon finding, comprising about 6‑14% of patients with MM. The most common causes of MM‑associated PE are congestive heart failure, renal failure, parapneumonic effusion and amyloidosis. In <1% of cases, the effusion is a direct result of MM, designated as myelomatous PE (MPE). MPE is usually a diagnosis of exclusion and carries a poor prognosis. Therefore, efforts should be made to optimally detect MPE. The present report describes an MPE associated with IgG/λ MM presenting as a septic shock and renal failure in which a rare diagnosis was made after excluding all other possible etiologies in a complex intensive care patient.

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