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Canadian Respiratory Journal
Volume 20, Issue 4, Pages 253-255
Clinico-Pathologic Conferences

Dyspnea, Massive Effusion and Lytic Rib Lesion as Initial Presentation of Multiple Myeloma in a Young Man

Mohammed H AlShati,1 Ramesh Kumar,2 and Shreeram Kannan3

1Division of Respirology, Al-Adan Hospital, Ahmadi, Kuwait
2Division of Hematology, Al-Adan Hospital, Ahmadi, Kuwait
3Department of Radiology, Al-Adan Hospital, Ahmadi, Kuwait

Copyright © 2013 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Multiple myeloma, a disorder commonly encountered in elderly patients, represents a malignant proliferation of plasma cells that primarily affects bone marrow. Pleural effusion as the presenting manifestation of the disease is uncommon. The authors report a case of multiple myeloma with unusual features presenting at a relatively young age with massive spontaneous hemothorax and multiple thoracic masses completely obscuring rib shadow on plain chest imaging. The patient demonstrated a good response to melphalan chemotherapy without recurrence of effusion or the need for additional chemical or surgical pleural interventions.