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  • Title: Unilateral pleural effusion as a presenting manifestation of plasma cell myeloma (multiple myeloma): a case report.
    Author: Dharan M.
    Journal: Acta Cytol; 2010; 54(5 Suppl):780-2. PubMed ID: 21053539.
    Abstract:
    BACKGROUND: Malignant pleural effusion caused by multiple myeloma (MM) is rare, occurring as a late complication with a poor prognosis. Myelomatous pleural effusion (MPE) as an initial manifestation of the disease is extremely uncommon. CASE: A 54-year-old, previously healthy man presented with right-sided pleural effusion. Cytologic examination of the aspirated fluid revealed large, slightly pleomorphic atypical cells, some having eccentric nuclei. Immunocytochemistry (ICC) performed on cytospin smears and cell block sections gave a positive reaction for CD138, EMA and vimentin and a negative reaction for CK7, CK20, calretinin, S-100 and E-cadherin. CONCLUSION: Cytopathologists may be caught unawares by atypical presentations of hematologic malignancies. The diagnosis of MPE requires a high level of suspicion, and routine incorporation of ICC in the cytologic evaluation will ensure accurate diagnosis and proper patient management.
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