Pulmonale und pleurale Manifestationen beim Plasmozytom

Multiple myeloma is a low malignant, non-Hodgkin's lymphoma, which is characterised by infiltration of the bone marrow by clonal prolifaration of atypical plasma cells. Clinical presentation is mostly determined by the sequeles of displacement of normal hemopoiesis, destruction of bones and the immune deficiency. Extramedullary manifestations are relatively rare. Pulmonary and pleural involvement has been described in case reports only. We report on a 75-year-old male patient in whom an IgG-secreting multiple myeloma type lambda (λ), stage III (according to Durie and Salmon) has been diagnosed. Chest X-ray and CT revealed a diffuse confluent nodular pattern in the lungs and a large left-sided pleural effusion. Histology and immunohistochemistry confirmed diffuse infiltration of the lungs as well as the pleura by dysmature plasma cells with deposition of λ-light chains. Preliminary treatment with vincristine and prednisone followed by polychemotherapy according to the VAD scheme was performed, which led to resolution of the pleuropulmonary changes.