Table 2 - available via license: Creative Commons Attribution-NonCommercial 4.0 International
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Multiple myeloma (MM) is a neoplastic proliferation of plasma cells with overproduction of monoclonal immunoglobulins and infiltration into the bone and other organs. Ascites can develop in patients with lymphoproliferative and solid malignancies involving the peritoneum. However, ascites is unusual in MM and rarely the initial presenting sign or s...
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Context 1
... effusions are twice as common as peritoneal ascites. Ascites due to peritoneal involvement in MM can be differentiated from secondary ascites due to hepatic involvement, heart failure, or kidney failure based on SAAG, total protein, and cell count ( Table 2). The cytological detection of plasma cells in ascitic fluid can be difficult because of their highly atypical appearance and similarity to reactive mesothelial cells. ...
Citations
... 7 Infectious peritonitis due to tuberculosis and spontaneous bacterial peritonitis (SBP) can also be an intrinsic secondary cause of ascites but is usually differentiated from malignant plasmacytic ascites based on an ascitic fluid cytology analysis. 8,9 Since the atypical plasma cells detected on cytology of the fluid might appear similar to reactive mesothelial cells, further testing methods such as flow cytometry, immunofluorescence, or electron microscopy should be employed. 8 Herein, we describe a case of malignant plasmacytic ascites and pleural effusion that was initially treated as SBP. ...
... 8,9 Since the atypical plasma cells detected on cytology of the fluid might appear similar to reactive mesothelial cells, further testing methods such as flow cytometry, immunofluorescence, or electron microscopy should be employed. 8 Herein, we describe a case of malignant plasmacytic ascites and pleural effusion that was initially treated as SBP. A 70-year-old male patient with an initial presentation of back pain and difficulty walking was diagnosed with IgD lambda subtype of International Staging System (ISS) stage II MM 8 years prior to current presentation with only bony lesions and without renal disease. ...
... Computed tomography (CT) scan of the abdomen revealed multiple peritoneal nodules, mesenteric and omental thickening. Both this and another MM patient reported by Abdulsamad et al presented with ascites at initial diagnosis, unlike our patient who suffered from multiple relapses over 7-8 years and ultimately developed extra-osseous complications at an advanced stage of MM. 7,8 The body cavities are not unusual sites of metastasis, but the pathophysiology of their involvement is poorly understood. A pleural or peritoneal biopsy may show extensive plasma cell infiltration, but it is not necessary for diagnosis. ...
Extramedullary multiple myeloma is seen in advanced and aggressive disease and occurs due to plasma cell infiltration of sites other than the bone marrow. Myelomatous ascites or pleural effusion is seen in less than 1% of cases and can be differentiated from infectious etiologies based on fluid cytology. Myelomatous effusion predicts poor outcomes in the relapsed and refractory multiple myeloma. It is important to differentiate malignant plasmacytic ascites and pleural effusion from infectious effusions as treatment is different.
... [7] Infectious peritonitis due to tuberculosis and spontaneous bacterial peritonitis (SBP) can also be an intrinsic secondary cause of ascites but is usually differentiated from malignant plasmacytic ascites based on an ascitic fluid cytology analysis. [8] [9] Since the atypical plasma cells detected on cytology of the fluid might appear similar to reactive mesothelial cells, further testing methods such as flow cytometry, immunofluorescence, or electron microscopy should be employed. [8] Herein, we describe a case of malignant plasmacytic ascites and pleural effusion that was initially treated as SBP. ...
... [8] [9] Since the atypical plasma cells detected on cytology of the fluid might appear similar to reactive mesothelial cells, further testing methods such as flow cytometry, immunofluorescence, or electron microscopy should be employed. [8] Herein, we describe a case of malignant plasmacytic ascites and pleural effusion that was initially treated as SBP. ...
... Computed tomography (CT) scan of the abdomen revealed multiple peritoneal nodules, mesenteric and omental thickening. Both this and another MM patient reported by Abdulsamad et al presented with ascites at initial diagnosis unlike our patient who suffered from multiple relapses over 7 to 8 years and ultimately developed extra-osseous complications at an advanced stage of MM. [7,8] The body cavities are not unusual sites of metastasis, but the pathophysiology of their involvement is poorly understood. A pleural or peritoneal biopsy may show extensive plasma cell infiltration, but it is not necessary for diagnosis. ...
Extramedullary multiple myeloma is seen in advanced and aggressive disease and occurs due to plasma cell infiltration of sites other than the bone marrow. Myelomatous ascites or pleural effusion is seen in less than 1 % of cases and can be differentiated from infectious etiologies based on fluid cytology.
... Multiple myeloma represents 1% of all malignancies and 10-15% of hematological malignancies [3]. It occurs more often in adults, and the highest incidence of disease is Seventh decade [4,5]. When diagnosing this malignancy, several clinical and laboratory features are useful, including: ...
Multiple myeloma is a hematological malignancy associated with increased plasma cell proliferation in the patient's bone marrow. HIV infection is an immunodeficiency disease that is present in some malignancies, such as non-Hodgkin's lymphomas, as an effective factor in the progression of malignancy. Our patient was diagnosed with multiple myeloma and after bone marrow transplantation, it became clear that the patient was HIV positive and also, he had a mild toxoplasmosis infection. After diagnosis, the patient was treated with antiviral drugs and drugs for the treatment of toxoplasma infection. After several months and carrying out the relevant tests, it indicates the control of HIV viral infection, and the patient is still being treated and followed up. Nonetheless, our case features the significance of HIV testing in early malignancy.
