Pleural effusion as first extra-medullary clinical presentation of an occult multiple myeloma: The role of medical thoracoscopy

Coppola, Antonietta; Ghinassi, Giacomo; Ciarleglio, Giuseppina; Maccari, Uberto; Salerno, Laura; Torricelli, Elena; Granese, Valentina; Valentini, Maria Lucia; Zamparelli, Alessandro Sanduzzi; Torre, Valerio; Scala, Raffaele

doi:10.1016/j.rmcr.2020.101013

Cited by 2 publications

(5 citation statements)

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“…MPE is commonly considered as a late manifestation of MM; 11 however, few reports have also described MPE as an early clinical finding. [12][13][14][15] As in our case, respiratory clinical signs secondary to MPE may be the only clinical sign leading to the diagnosis of MM. 12,13,16 Pleural effusion secondary to congestive heart failure due to hyperviscosity, renal failure, pulmonary embolism, chylothorax, haemorrhage and infection are also common in patients diagnosed with MM and are reported in 6-14% of cases.…”

Section: Discussionsupporting

confidence: 61%

“…[12][13][14][15] As in our case, respiratory clinical signs secondary to MPE may be the only clinical sign leading to the diagnosis of MM. 12,13,16 Pleural effusion secondary to congestive heart failure due to hyperviscosity, renal failure, pulmonary embolism, chylothorax, haemorrhage and infection are also common in patients diagnosed with MM and are reported in 6-14% of cases. 10,15,17 Therefore, clinicians must be advised of these causes as some are treatable and carry a better prognosis than MPE.…”

Section: Discussionsupporting

confidence: 61%

“…MPE is commonly considered as a late manifestation of MM; 11 however, few reports have also described MPE as an early clinical finding. 12 – 15 As in our case, respiratory clinical signs secondary to MPE may be the only clinical sign leading to the diagnosis of MM. 12 , 13 , 16…”

Section: Discussionsupporting

confidence: 58%

“… 12 – 15 As in our case, respiratory clinical signs secondary to MPE may be the only clinical sign leading to the diagnosis of MM. 12 , 13 , 16…”

Section: Discussionsupporting

confidence: 58%

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Myelomatous pleural effusion in a cat diagnosed with multiple myeloma

Amalbert

Canonne-Guibert

Béguin

2023

Journal of Feline Medicine and Surgery Open Reports

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Case summary A 10-year-old male castrated domestic shorthair cat was presented with a 3-day history of dyspnoea, chronic lethargy and inappetence. A bilateral pleural effusion was identified by thoracic ultrasound, and cytological examination revealed numerous atypical plasma cells. Biochemistry and serum protein electrophoresis revealed a severe hyperglobulinaemia associated with a monoclonal gammopathy. A moderate non-regenerative anaemia was also noted. Multiple bone lytic lesions were detected, and marked plasmacytosis was observed on bone marrow aspirates. Chemotherapy with cyclophosphamide and prednisolone was initiated but did not result in any clinical or biological response, and pleural effusion recurred. Lack of therapeutic response led to euthanasia 2 months after diagnosis. Relevance and novel information This is the first description of a myelomatous pleural effusion in a cat diagnosed with multiple myeloma and should be considered as one of the possible differential diagnoses for cats presented with pleural effusion and hyperglobulinaemia. The diagnostic, therapeutic and prognostic aspects of this manifestation are discussed.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionsupporting

confidence: 61%

Section: Discussionsupporting

confidence: 58%

“… 12 – 15 As in our case, respiratory clinical signs secondary to MPE may be the only clinical sign leading to the diagnosis of MM. 12 , 13 , 16…”

Section: Discussionsupporting

confidence: 58%

See 2 more Smart Citations

Myelomatous pleural effusion in a cat diagnosed with multiple myeloma

Amalbert

Canonne-Guibert

Béguin

2023

Journal of Feline Medicine and Surgery Open Reports

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“…It is reported that the pleural effusion seen in MM is due to the accompanying diseases rather than the underlying primary disease (less than 1%) [26]. The patient with MM in our cohort had hypertension and heart failure as additional diagnoses.…”

Section: Discussionmentioning

confidence: 62%

Long-term follow-up results of patients diagnosed with nonspecific pleuritis by video-assisted thoracoscopic surgery biopsy

et al. 2020

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IntroductionNon-specific pleuritis (NSP) is a fibrinous or inflammatory pleurisy that is not attributable to a benign or malign etiology. The long-term follow-up results of patients diagnosed with NSP following video- assisted thoracoscopic surgery (VATS) were investigated in this study.Material and methodsThis investigation focused on 593 patients with exudative pleural effusion who underwent VATS between 2011 and 2014. Of the 137 patients diagnosed with NSP, a total of 39 patients were excluded from the study.ResultsOut of the 98 patients, 78 were male (80%) with their mean age being 52.2 ±15.9 years. The mean follow-up period was 1919 ±744 days. Of these patients, 70 (71.4%) had no specific diagnosis, while 28 patients (28.6%) did have specific diagnoses. Malignancy was detected in seven (7.1%) of those with specific diagnoses, with most of the diagnoses of malignancy detected within the first 36 months. Malignant diseases included mesothelioma (n = 2), lung cancer (n = 2), chronic lymphocytic leukemia (n = 1), soft tissue sarcoma (n = 1), and multiple myeloma (n = 1). Chest radiographs of malignant patients showed that statistically significantly larger amounts of fluid (40% vs. 6.9%, p = 0.026), pleural plaque (20% vs. 1.1%, p = 0.020) and nodules (20% vs. 7.7%, p = 0.020) were detected compared to patients with a benign course.ConclusionsMost patients diagnosed with NSP after VATS had a benign disease course. There was a probability of malignancy, although it was low. Mesothelioma and other malignancies could be seen within the first 36 months after the biopsy. Apart from mesothelioma, other malignancies should also be considered, and further follow-up recommended for patients with a large amount of fluid, plaque and nodules found in the initial VATS images.

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Pleural effusion as first extra-medullary clinical presentation of an occult multiple myeloma: The role of medical thoracoscopy

Cited by 2 publications

References 5 publications

Myelomatous pleural effusion in a cat diagnosed with multiple myeloma

Myelomatous pleural effusion in a cat diagnosed with multiple myeloma

Long-term follow-up results of patients diagnosed with nonspecific pleuritis by video-assisted thoracoscopic surgery biopsy

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