Pleural effusion in patients with multiple myeloma due to plasma cell involvement of the pleura has been reported infrequently and has not yet been reported in Korea.
We report a case of multiple myeloma with pleural involvement presenting dyspnea and pain in the left arm in a 56-year-old women.
On the physical examination, the patient looked chronic ill. There was a palpable mass
on the right skull, firm but not tender and decreased breathing sound in the left lung.
On the neurologic exam, the patient had difficult lateral gaze in the right eyeball movement.
Laboratory findings revealed anemia, elevation of ESR, globulin, RUN and creatinine.
X-ray of the chest showed pleural effusion in the left lung. X-ray of the skull, both humerus and pelvis revealed multiple punched-out osteolytic lesions, pathologic fracture
in the left humerus and compression fracture in the lumbar spine.
The CT examination of chest showed biliateral pleural effusion and rib mass lesions.
Serum and urine electrophoresis revealed a M-spike. Serum and urine immunoelectrophoresis demonstrated an IgG-Kappa monoclonal protein.
Thoracentesis revealed serosanguineous fluid containing atypical plasma cells. Bone marrow examination showed 56% of immature plasma cells.
With first cycle of vincristine, melphalan, prednisonecombination chemotherapy, improvement of pain and eyeball movement, disappearance of pleural effusion was observed. After second cycle of the same chemotherapy, her condition deteriorated and she died due to renal failure.

Keywords: Multiple myeloma, Pleural effusion