Pulmonary involvement in multiple myeloma is very uncommon. In the case to be presented, extraosseous pleuropulmonary involvement was a dominant feature.
A 69-year-old man, a farmer, was admitted to our hospital with a chief complaint of anorexia on August 21.1978. A test for Bence Jones protein was positive. The erythrocyte sedimentation rate was 66mm/hr. The serum total protein was 8.1g/dl and a monoclonal pattern was observed in γ-globulin area. X-ray films of the bones showed generalized osteoporosis and punched-out lesions in the skull. X-ray films of the chest revealed a mass with an ill-defined margin in the right hilar region, measuring 3×3.5cm in its greatest dimensions, extrapleural signs associated with pleural fluid in the left lung field, and also polycystic shadows in the left lower lung field. A lot of myeloma cells and M-protein were revealed in the pleural fluid. The patient was diagnosed as IgG, λ-type multiple myeloma on immunoelectrophoretic examination of the serum, urine, and pleural fluid. Treatment with corticosteroids and cyclophosphamide was quite ineffective and he died in 2 months.
