The University of Toledo Translation Journal of Medical Sciences 
Pulmonology Abstract, Department of Medicine Research Symposium UTJMS 2023 May 5; 11(1):e1-e1 

Pleural plasmacytomas in a Patient with Multiple 
Myeloma Relapse 

Harith Adnan Al-Ataby, MD1*, Mohamed Omballi MD1 
1Division of Pulmonology and Critical Care Medicine, Department of Medicine, The 
University of Toledo, Toledo, OH 43614 

*Corresponding author: harith.al-ataby@utoledo.edu

Published: 05 May 2023 

Introduction: Pleural plasmacytoma in the setting of relapsed multiple myeloma (MM) is a rare yet 
serious condition, less than 10 cases have been reported in the literature. 

Case Report: A 66-year-old woman with history of IgA lambda MM diagnosed 10 years ago. She 
remained in remission for about 9 years. She presented with dyspnea on exertion with decrease breathing 
sound in the right side of the chest. CXR showed moderate right side pleural effusion and PET/CT scan 
revealed multiple lytic lesions and PET-avid foci in the skeleton and pleural soft tissue lesions. 
Thoracoscopy with pleural mass biopsy confirmed the diagnosis of extramedullary plasmacytomas in the 
setting of multiple myeloma relapse. The patient was started on pomalidomide, bortezomib, and 
dexamethasone.  

Discussion: Pleural plasmacytomas are extremely rare and account for around 3-6% of extramedullary 
disease in MM patients. FDG-PET/CT allows the examination of the whole body in a single and faster 
study, and can help identify active disease in patients with relapsed or refractory MM. Pulmonary 
nodules or pleural lesions can be diagnosed by performing a transbronchial biopsy, CT-guided needle 
biopsy, or a surgical biopsy through open thoracotomy, medical thoracoscopy (MT) or video-assisted 
thoracoscopic surgery (VATS). MT has excellent accuracy and is less invasive, thus has increasingly 
been used. The treatment of solitary extramedullary plasmacytomas, including pleural plasmacytomas, is 
with radiation. The treatment of extramedullary plasmacytomas in the setting of MM relapse is a 
multimodal approach using different strategies, such as advanced radiotherapy techniques, 
immunomodulatory agents and proteasome inhibitors. 

https://dx.doi.org/10.46570/utjms.vol11-2023-770 

https://dx.doi.org/10.46570/utjms.vol11-2023-770
mailto:harith.al-ataby@utoledo.edu