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Case Reports
. 2016 Jul 15;4(8):803-6.
doi: 10.1002/ccr3.634. eCollection 2016 Aug.

Primary malignant myelomatous pleural effusion

Ankit Mangla  1 , Nikki Agarwal  2 , George J Kim  3 , Rosalind Catchatourian  1
Affiliations
Case Reports

Primary malignant myelomatous pleural effusion

Ankit Mangla et al. Clin Case Rep. .

Abstract

Primary malignant myelomatous pleural effusion (PMMPE) occurs in less than 1% of patients with multiple myeloma and is diagnosed either by visualization of plasma cells on cytology or by positive flow cytometry. The presence of immature plasma cells characterized by high nucleus to cytoplasm ratio, visible nucleolus and presence of Mott cells and Russell bodies are independent poor prognostic factors. The clinician should differentiate PMMPE from secondary pleural effusion as it is associated with a significantly worse prognosis and poor overall survival.

Keywords: Mott cells; Russell bodies; multiple myeloma; pleural effusion.

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Figures

Figure 1
Figure 1
CT chest showing large pleural effusion with collapsed lobe of the lung, right mediastinal shift, and pleural thickening due to metastasis to pleura (marked by red arrows).
Figure 2
Figure 2
Panel A – Numerous plasma cells seen in the pleural effusion. Panel B – Multilobed plasma cell. Panel C – Bilobed plasma cell. Panel D – Numerous immature plasma cells (multilobed nucleoli, visible nucleolus, high nuclear to cytoplasmic ratio).
Figure 3
Figure 3
Mott cells: Russell bodies seen within the cytoplasm as vesicles and dilated endoplasmic reticulum cisternae.
See this image and copyright information in PMC

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