Co-incidental presentation of IgA lambda multiple myeloma and pleural involvement with IgM kappa non-Hodgkin's lymphoma

Pleural effusions occur in approximate to 6% of patients with myeloma, The aetiology is multifactorial and effusions due to pleural myelomatous involv ement are rare, occurring in < 1% of cases. We report the case of a 68-year -old lady who presented with IgA myeloma and a concurrent pleural effusion due to a second IgMK producing B cell neoplasm. The former responded but th e latter was resistant to standard myeloma therapy.