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. 2020 Jan 22;2(2):279-281.
doi: 10.1016/j.jaccas.2019.11.034. eCollection 2020 Feb.

Rapidly Progressive Atrial Mass and Cardiac Tamponade: A Rare Presentation of Multiple Myeloma

Jeet Ram Kashyap  1 , Anita Tahlan  2 , Suraj Kumar  1 , Sreenivas Reddy  1 , Reetu Kundu  2
Affiliations

Rapidly Progressive Atrial Mass and Cardiac Tamponade: A Rare Presentation of Multiple Myeloma

Jeet Ram Kashyap et al. JACC Case Rep. .

Abstract

Cardiac involvement in multiple myeloma is rare. We report a rapidly progressive atrial mass and plasma cell-infiltrated pericardial effusion with tamponade. Bone marrow biopsy and plasma immunoelectrophoresis confirmed multiple myeloma (Revised International Staging System Stage III). The patient died within 18 weeks of presentation, suggesting aggressive disease with poor prognosis. (Level of Difficulty: Beginner.).

Keywords: MM, multiple myeloma; PE, pericardial effusion; atrial mass; cardiac tamponade; extramedullary plasmacytoma; multiple myeloma; plasma cells.

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Figures

Figure 1
Figure 1
Color Doppler Echocardiography (A) Apical 4-chamber (4C) and subcostal views showing dumbbell-shaped interatrial septum mass (red arrows) with mild PE (yellow arrow). Sequential echocardiography (Echo) at 5 weeks (B) and 11 weeks (C) showing increase in size of mass and PE. (D) Computed tomographic scan of the chest showing a mass (red arrows) and a large PE (thick white arrow).Short white arrows indicate pleural effusion. Long white arrows indicate erosion of ribs. (E, F) Pericardial fluid cytology (yellow arrows) (E) and bone marrow biopsy (F) showing 67% plasma cells (black arrowheads) (40× magnification). 2D = 2-dimensional; PE = pericardial effusion.
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References

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