Journal of Cytology
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CASE REPORT
Year : 2007  |  Volume : 24  |  Issue : 2  |  Page : 101-102

Myeloma presenting as bilateral pleural effusion - a cytological diagnosis


Department of Pathology, Maulana Azad Medical College and Lok Nayak Hospital, Bahadur Shah Zafar Marg, New Delhi 110002, India

Correspondence Address:
S Jain
20/59 Lodhi Colony, New Delhi- 110003
India
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Source of Support: None, Conflict of Interest: None


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Multiple myeloma presenting as a pleural effusion is extremely rare. It is usually a late complication and is associated with a poor prognosis. A 40-year-old male presented with dyspnea and fever of six months duration. Clinical diagnosis of pulmonary tuberculosis was considered. Chest radiograph showed bilateral pleural effusion. Pleural cytology revealed numerous plasma cells, some of which were binucleated and atypical. Cytological differential diagnosis included myelomatous effusion and non-Hodgkin's lymphoma (immunoblastic type) deposit. Bone marrow biopsy, serum protein electrophoresis and bone scan confirmed the diagnosis of multiple myeloma (plasmablastic type). Myelomatous pleural effusion as an initial presentation although extremely rare, should always be considered in presence of atypical plasma cells in body fluids irrespective of age.


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