Can multiple myeloma cause pleural effusion?
Pleural effusion is uncommon in multiple myeloma; it has been suggested that it occurs in approximately 6% of cases. Most of these are not directly due to myelomatous infiltration but to related pathologies such as pulmonary embolus, heart failure and nephrotic syndrome.
What is the survival rate of those with malignant pleural effusion?
Development of a malignant pleural effusion is associated with a very poor prognosis, with median survival of 4 months and mean survival of less than 1 year.
What cells are found in pleural fluid?
The composition of normal pleural fluid consists of total white blood cell count of 1.716 x 10(3) cells mL(-1). Differential cell counts: 75% macrophages, 23% lymphocytes, and marginally present mesothelial cells (1% to 2%), neutrophils (1%), and eosinophils (0%).
Does multiple myeloma affect the lungs?
Pulmonary involvement with multiple myeloma occurs infrequently and may be difficult to distinguish from more common primary lung tumours, metastatic disease, or other pleural and parenchymal abnormalities.
Can chemo cure malignant pleural effusion?
Systemic chemotherapy is generally disappointing for the control of malignant pleural effusions. When the underlying malignancy is chemo-sensitive, systemic chemotherapy might be the treatment of choice for malignant pleural effusion.
Does pleural effusion mean death?
The presence of a pleural effusion indicates a high risk of death, with 15% of patients dying within 30 days and 32% dead within one-year of hospital admission.
What are the normal cells seen in pleural fluid?
Differential cell counts yielded median 75% (IR 16%) macrophages, 23% (IR 18%) lymphocytes, and marginally present mesothelial cells (1%, IR 2%), neutrophils (0%, IR 1%) and eosinophils (0%, IR 0%).
How do you count cells in pleural fluid?
PL with an instilled volume of 150 ml of saline therefore represents a dilution factor of (150 + 8.4): 8.4 = 18.86. Hence, the median total WBC count of 91 × 103 cells/ml in the diluted PL fluid corresponds to a total WBC count of 91 × 18.86 = 1,716 × 103 WBC/ml in the original pleural fluid.
Can multiple myeloma cause pneumonia?
“We found the risk of specific infections, such as pneumonia and septicemia to be more than 10 times higher in patients than in controls during the first year after diagnosis of multiple myeloma.” The infection rate doubled between the earliest and latest years included in the analysis, which spanned 1988 to 2004.
Can multiple myeloma cause shortness of breath?
Myeloma protein can damage the kidneys, resulting in shortness of breath, weakness, itching, and swelling in the legs.
How many times can you drain a pleural effusion?
After catheter insertion, the pleural space should be drained three times a week. No more than 1,000 mL of fluid should be removed at a time—or less if drainage causes chest pain or cough secondary to trapped lung (see below).
Is there pleural effusion in multiple myeloma patients?
Objective: Pleural effusion is rarely observed in patients with multiple myeloma (MM). Myeloma cell infiltration or invasion to the pleura is very rare. This study aimed to investigate the clinical characteristics of pleural effusion in patients with MM.
Can a pleura be infiltrated by malignant cells?
However, in 1% of patients alone the pleura is infiltrated by malignant plasma cells resulting in MPE. 4 This is usually seen late in the disease process, is associated with grave prognosis.
What is the white blood cell count of pleural fluid?
A sample of the pleural fluid had a total protein concentration of 38 g/L and a white blood cell count of 20.5 × 10 9 /L, with 100% lymphoid cells. The results of bacterial and mycobacterial cultures were negative.
How often is pleural effusion found in MM patients?
A pleural effusion is found in about 6% of MM cases, but myelomatous pleural effusion is uncommon, with <100 cases having been reported worldwide. A basic biochemical exploration of an MM-associated pleural effusion should include protein electrophoretic analysis of the serum and pleural fluid, combined with an anatomic pathology study.