OBJECTIVE: Discuss and improve the understanding of the clinical characters and diagnostic methods of myelomatous pleurisy, particularly of the patients with pleural effusion as an initial manifestation. BACKGROUND: A 53-year-old male, who had been misdiagnosed as tuberculous pleurisy in a local hospital, was diagnosed as multiple myeloma (MM) with pleural infiltration. We reviewed the literature on clinical manifestations, serum and pleural effusion characters, treatment and diagnostic options of this exceptionally rare presentation of MM. METHODS: We conducted a search of the published medical literature since 2000 in MEDLINE and PubMed using search criteria [("pleural effusion" and "MM") or "myelomatous pleural effusions"]. The search led to 64 case reports, and 16 cases with pleural effusion as an initial manifestation were included in this review. We have also searched for recent advances in diagnosis. RESULTS AND CONCLUSIONS: Myelomatous pleurisy is a rare complication of MM. Its clinical and laboratory findings are non-specific. Definitive diagnosis relies on the histopathology of pleural biopsy or pleural effusion. Thoracoscopic pleural biopsy is reliable, safe and effective. Chemotherapy is the mainstay of treatment for myelomatous pleural effusion. However, the response rate is low with an overall median survival time of 4 months.
OBJECTIVE: Discuss and improve the understanding of the clinical characters and diagnostic methods of myelomatous pleurisy, particularly of the patients with pleural effusion as an initial manifestation. BACKGROUND: A 53-year-old male, who had been misdiagnosed as tuberculous pleurisy in a local hospital, was diagnosed as multiple myeloma (MM) with pleural infiltration. We reviewed the literature on clinical manifestations, serum and pleural effusion characters, treatment and diagnostic options of this exceptionally rare presentation of MM. METHODS: We conducted a search of the published medical literature since 2000 in MEDLINE and PubMed using search criteria [("pleural effusion" and "MM") or "myelomatous pleural effusions"]. The search led to 64 case reports, and 16 cases with pleural effusion as an initial manifestation were included in this review. We have also searched for recent advances in diagnosis. RESULTS AND CONCLUSIONS:Myelomatous pleurisy is a rare complication of MM. Its clinical and laboratory findings are non-specific. Definitive diagnosis relies on the histopathology of pleural biopsy or pleural effusion. Thoracoscopic pleural biopsy is reliable, safe and effective. Chemotherapy is the mainstay of treatment for myelomatous pleural effusion. However, the response rate is low with an overall median survival time of 4 months.
Authors: Philip R Greipp; Jesus San Miguel; Brian G M Durie; John J Crowley; Bart Barlogie; Joan Bladé; Mario Boccadoro; J Anthony Child; Herve Avet-Loiseau; Jean-Luc Harousseau; Robert A Kyle; Juan J Lahuerta; Heinz Ludwig; Gareth Morgan; Raymond Powles; Kazuyuki Shimizu; Chaim Shustik; Pieter Sonneveld; Patrizia Tosi; Ingemar Turesson; Jan Westin Journal: J Clin Oncol Date: 2005-04-04 Impact factor: 44.544
Authors: Y M Kim; K K Lee; H S Oh; S K Park; J H Won; D S Hong; H S Park; J S Park; D W Lee Journal: J Korean Med Sci Date: 2000-04 Impact factor: 2.153