PERICARDIAL-EFFUSION, A RARE COMPLICATION OF MULTIPLE-MYELOMA - REPORT OF A CASE WITH A REVIEW OF THE LITERATURE

A 68-year-old man was diagnosed with IgG kappa myeloma, stage I accord ing to the Durie and Salmon classification. Four months later he was a dmitted for right-sided heart failure. A pericardial effusion responsi ble for tamponade was found, Numerous malignant plasmocytes were ident ified in the pericardial aspirate. After aspiration, the amount of per icardial fluid remained small and stable under chemotherapy. However, lysis of the ribs and rapid growth of a mediastinal tumor occurred aft er four months under chemotherapy, and the patient died of pneumonia., Only eight other cases of-pericarditis due to myeloma have been repor ted, Mean survival was less than seven months, Regarding pathogenesis, hematogenous dissemination was probably not involved since no plasmoc ytes were found in peripheral blood, Neither were there any myeloma le sions in contiguous tissues (ribs, pleura). The presence of plasmocyte -rich mediastinal and hilar lymphadenopathy at the time of development of the pericarditis suggests that spread occurred via the lymphatic v essels.