Co-incidental presentation of IgA lambda multiple myeloma and pleural involvement with IgM kappa non-Hodgkin’s lymphoma

Abstract

Pleural effusions occur in approximately 6% of patients with myeloma. The aetiology is multifactorial and effusions due to pleural myelomatous involvement are rare, occurring in < 1% of cases. We report the case of a 68-year-old lady who presented with IgA myeloma and a concurrent pleural effusion due to a second IgM kappa producing B cell neoplasm. The former responded but the latter was resistant to standard myeloma therapy.

Cytomorphology, clinicopathologic, and cytogenetics correlation of myelomatous effusion of serous cavities: A retrospective review

“…Effusions are relatively common affecting about 6% myeloma patients. The most common causes are sepsis, heart failure secondary to amyloidosis, hypoalbuminemia, or chronic renal failure . Myelomatous involvement of body cavity fluids is unusual, affecting <1% of patients, with pleural effusions is most common followed by peritoneal effusions, while pericardial effusions are rare …”

Cytomorphology, Clinicopathologic and Cytogenetics Correlation of Myelomatous Effusion of Serous Cavities: A Retrospective Review

“…The most common causes are sepsis, heart failure secondary to amyloidosis, hypoalbuminemia, or chronic renal failure. 8 Myelomatous involvement of body cavity fluids is unusual, affecting <1% of patients, with pleural effusions is most common followed by peritoneal effusions, while pericardial effusions are rare. 8,9 Similar to previous studies, thirteen of 797 patients treated for multiple myeloma at our institution developed myelomatous serous cavity effusions.…”

Bilateral Pleural Effusions due to Pulmonary Amyloidosis as the Presenting Manifestation of Multiple Myeloma

“…MM can be complicated by nephrotic syndrome, chronic renal failure, restrictive amyloid cardiomyopathy, and pulmonary embolism, which can all result in pleural effusion. Direct myeloma involvement of the pleural space is extremely rare occurring in < 1% of cases 8. Infectious etiology of effusion is common due to associated hypogammaglobulinemia.…”