[A case of multiple myeloma associated with abnormal plasma cells and M-protein in pleural effusion].
A 77-year-old woman with hypertension was admitted to our hospital because of exertional dyspnea end peripheral edema. Chest X-ray showed cardiomegaly, pulmonary congestion and right pleural effusion. Hypertensive heart failure was diagnosed and treated, and right pleural effusion disappeared in 2 weeks. Abnormalities on laboratory data, i.e. anemia and increased ESR et al. continued after the improvement of heart failure. Serum IgG was elevated (2570 mg/dl), while IgA and IgM were decreased. Immunoelectrophoresis indicated the presence of monoclonal IgG-lambda in the serum. Bone marrow puncture revealed an increase in atypical plasma cells (38.4%). Multiple myeloma was diagnosed from these findings and treated with melphalan and prednisolone. But increases in atypical plasma cells (43.2%) and serum IgG (2573 mg/dl) continued. During treatment, right pleural effusion increased again. Thoracocentesis showed bloody effusion with numerous atypical plasma cells, and the presence of monoclonal IgG-lambda was indicated by immunoelectrophoresis. The patient died of renal and heart failure 2 months after the onset of malignant pleural effusion. Cytological examination and immunoelectrophoresis are necessary for pleural effusion in multiple myeloma.
Araki
T
T
Department of Internal Medicine, Saisaikai Kanazawa Hospital, Japan.
Tofuku
Y
Y
D000368:Aged; D064211:Connectin; D005260:Female; D006801:Humans; D009101:Multiple Myeloma / Q000150:complications*; D009124:Muscle Proteins; D009194:Myeloma Proteins / Q000378:metabolism*; D010950:Plasma Cells / Q000473:pathology*; D010996:Pleural Effusion / Q000737:chemistry* / Q000473:pathology*
D064211:Connectin; D009124:Muscle Proteins; D009194:Myeloma Proteins; C085016:multiple myeloma M-proteins