Massive myelomatous pleural effusion: a report of rare manifestation of a patient with multiple myeloma

Abstract

Multiple myeloma is a clonal plasma cell disorder with significant symptoms or organ dysfunction. According to the World Health Organisation (WHO) classification of tumours of hematopoietic and lymphoid tissues, myeloma is categorised in a subset of terminally differentiated mature B-cell neoplasms. Patients usually present with anaemia, renal impairment, symptoms of hypercalcemia and bone pain or fractures. Myelomatous pleural effusion is a rare complication and more likely found among multiple myeloma patients with progressive or refractory disease. We present herein a case of a patient with myeloma who developed massive pleural effusion after completing primary myeloma treatment at Thammasat University Hospital, Thailand. The effusion flow cytometry confirmed involvement of myeloma and systemic relapse simultaneously. Second-line therapy with bortezomib-based regimen was commenced; however, the patient’s condition rapidly deteriorated after the diagnosis was made. This case report aimed to cover the clinical course of a patient diagnosed with multiple myeloma with myelomatous pleural effusion.