title: Myelomatous pleural effusion: A rare presentation of multiple myeloma.
abstract: Myelomatous pleural effusion is a very rare presentation of multiple myeloma. A 65-year-old male patient presented to us with complaints of dyspnea and left-sided chest pain. His contrast enhanced computed tomography of the thorax showed left-sided pleural effusion with multiple pleural nodules. His pleural fluid cytology shows malignant plasma cells with eccentric nuclei and cart wheel chromatin and a few cells showing binucleation and multinucleation suggestive of plasma cell myeloma. His pleural fluid and serum electrophoresis showed a distinct band in the gamma globulin region (M-spike). On immunofixation of pleural fluid and serum, immunoglobulin G lambda light chain band was detected. Bone marrow aspiration showed sheets of malignant plasma cells with large and binucleated cells suggestive of multiple myeloma. The patient was diagnosed with multiple myeloma presenting as myelomatous pleural effusion. Intercostal tube drainage and then pleurodesis with talc was performed.
authors.affiliation: Department of Tuberculosis and Respiratory Diseases, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Shameem
authors.affiliation: Department of Tuberculosis and Respiratory Diseases, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India.
authors.forename: Jamal
authors.initials: J
authors.lastname: Akhtar
authors.affiliation: Department of Tuberculosis and Respiratory Diseases, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India.
authors.forename: Nafees Ahmad
authors.initials: NA
authors.lastname: Khan
authors.affiliation: Department of Tuberculosis and Respiratory Diseases, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India.
authors.forename: Ummul
authors.initials: U
authors.lastname: Baneen
authors.affiliation: Department of Tuberculosis and Respiratory Diseases, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Bhargava
authors.affiliation: Department of Tuberculosis and Respiratory Diseases, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India.
authors.forename: Zuber
authors.initials: Z
authors.lastname: Ahmed
authors.affiliation: Department of Tuberculosis and Respiratory Diseases, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Shahid
keywords: Multiple myeloma; myelomatous pleural effusion