IgG Lambda Myeloma Presenting as Plasmacytic Ascites: Case Report and Review of Literature

Abstract

Multiple myeloma is a neoplastic disease of plasma cells accounting for 13 % of haematological malignancies and 2 % of all malignancies worldwide. Ascites may develop very rarely during the course of disease in multiple myeloma. We report the case of a 78 years old male with IgG lambda multiple myeloma who initially presented with plasmacytic ascites. An exhaustive review of world literature reveals 65 cases of ascites to have been reported in myeloma over a span of 62 years (1952 till date), usually developing in the course of treatment. This is the 7th case of plasmacytic ascites to have been diagnosed at initial presentation. We review the clinical features, diagnosis, prognostic significance and treatment of such cases.

Keywords: Ascites; IgG lambda; Multiple myeloma; Plasmacytic ascites.

Fig. 1.

a CT (Computed tomography) scans of abdomen showing mesenteric thickening and peritoneal nodules b Bone marrow aspirate smears with increased plasma cells, and bi nucleate forms (modified Wright-Giemsa stain, ×400) c Numerous plasma cells in cell block preparation (modified Wright-Giemsa stain, ×400) d CD 138 positivity in plasma cells, cell block preparation (Immunoperoxidase, ×400)