Unveiling complexity: Chest wall swelling manifestation of extramedullary myeloma

Shrinil V Motka; Maulik K Varsat; Keyurkumar M Patel

doi:10.5455/njppp.2024.14.01030202401022024

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Online Publishing Date:
13 / 02 / 2024

Natl J Physiol Pharm Pharmacol. 2024; 14(7):

doi: 10.5455/njppp.2024.14.01030202401022024

Unveiling complexity: Chest wall swelling manifestation of extramedullary myeloma

Shrinil V Motka, Maulik K Varsat, Keyurkumar M Patel.

Abstract
There are two forms of myeloma: Solitary plasmacytoma and multiple myeloma. Both are malignant tumors and develop from bone marrow plasma cells, which secrete immunoglobulins. Pleural effusion secondary to myeloma is extremely rare, with an incidence of 1–2%. A 58-year-old man presented to the emergency department with a chief complaint of swelling and pain over the left side of his chest, breathlessness, generalized weakness, abdominal pain, and blood in his stool for 15 days. The chest X-ray posteroanterior view showed well-defined homogenous opacity in the left hemithorax. The patient underwent ultrasound-guided left-sided thoracocentesis. Pleural fluid was exudative, and cytology showed the presence of malignant cells. Contrast-enhanced computed tomography of the thorax and abdomen showed a well-defined soft-tissue density lesion involving the left posteriolateral chest wall with underlying rib erosion. For confirmation of malignant etiology, a USG-guided transthoracic needle biopsy was performed. A biopsy revealed a malignant round cell tumor in a histopathological review. For confirmation, a tissue sample was sent for immunohistochemistry markers, which had positivity for CD 138 and MUM 1, consistent with myeloma. Rarely, MM can present as chest wall swelling. Ultrasound is an easily available diagnostic modality that can be used for chest wall biopsy with a minimal incidence of complications.

Key words: Chest wall swelling, Extra-medullary myeloma, Multiple Myeloma, Plasmacytoma, Bone marrow, Plasma cells, Pleural effusion, Rib erosion, USG-guided, Transthoracic needle biopsy, CD 138, MUM 1

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Pubmed Style

Motka SV, Varsat MK, Patel KM. Unveiling complexity: Chest wall swelling manifestation of extramedullary myeloma. Natl J Physiol Pharm Pharmacol. Online First: 13 Feb, 2024. doi:10.5455/njppp.2024.14.01030202401022024

Web Style

Motka SV, Varsat MK, Patel KM. Unveiling complexity: Chest wall swelling manifestation of extramedullary myeloma. https://www.njppp.com/?mno=184492 [Access: March 14, 2024]. doi:10.5455/njppp.2024.14.01030202401022024

AMA (American Medical Association) Style

Motka SV, Varsat MK, Patel KM. Unveiling complexity: Chest wall swelling manifestation of extramedullary myeloma. Natl J Physiol Pharm Pharmacol. Online First: 13 Feb, 2024. doi:10.5455/njppp.2024.14.01030202401022024

Vancouver/ICMJE Style

Motka SV, Varsat MK, Patel KM. Unveiling complexity: Chest wall swelling manifestation of extramedullary myeloma. Natl J Physiol Pharm Pharmacol, [cited March 14, 2024]; Online First: 13 Feb, 2024. doi:10.5455/njppp.2024.14.01030202401022024

Harvard Style

Motka, S. V., Varsat, . M. K. & Patel, . K. M. (2024) Unveiling complexity: Chest wall swelling manifestation of extramedullary myeloma. Natl J Physiol Pharm Pharmacol, Online First: 13 Feb, 2024. doi:10.5455/njppp.2024.14.01030202401022024

Turabian Style

Motka, Shrinil V, Maulik K Varsat, and Keyurkumar M Patel. 2024. Unveiling complexity: Chest wall swelling manifestation of extramedullary myeloma. National Journal of Physiology, Pharmacy and Pharmacology, Online First: 13 Feb, 2024. doi:10.5455/njppp.2024.14.01030202401022024

Chicago Style

Motka, Shrinil V, Maulik K Varsat, and Keyurkumar M Patel. "Unveiling complexity: Chest wall swelling manifestation of extramedullary myeloma." National Journal of Physiology, Pharmacy and Pharmacology Online First: 13 Feb, 2024. doi:10.5455/njppp.2024.14.01030202401022024

MLA (The Modern Language Association) Style

APA (American Psychological Association) Style

Motka, S. V., Varsat, . M. K. & Patel, . K. M. (2024) Unveiling complexity: Chest wall swelling manifestation of extramedullary myeloma. National Journal of Physiology, Pharmacy and Pharmacology, Online First: 13 Feb, 2024. doi:10.5455/njppp.2024.14.01030202401022024

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