case_images: PMC11106595_01
case_images: Chest X-ray showing a pleural opacity in the left chest repressing the trachea and the mediastinum.
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case_images: The chest X-ray showed a left-sided pleural opacity with signs of compression ( Figure 1).
case_images: The chest ultrasound showed a massive, anechoic, free pleural effusion (red arrows) in the left side associated with a multinodular pleura (blue arrows).
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case_images: The thoracic ultrasound revealed a massive anechoic, free left pleural effusion associated with many pleural nodules ( Figure 2).
case_images: A mediastinal chest CT section revealing a massive pleural effusion in the left side (red arrows).
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case_images: We also noticed extended secondary bone and subcutaneous lesions ( Figure 3).
case_images: The 'grape-cluster' like aspect of the pleura as seen in medical thoracoscopy performed in our department of Pneumology.
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case_images: It showed a multinodular pleura with a "bunch of grapes" aspect ( Figure 4).
case_images: The Hematoxylin Eosin (HE) staining illustrates the presence of an undifferentiated abnormal rounded tumoral cells: (A): Envision (HE)*2, (B): Envision (HE)*40.
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case_images: The histological examination of the pleural guided biopsy smear showed an abnormal round cell tumor ( Figure 5), with an intense and diffuse positive staining for CD138 and MUM1 ( Figure 6), associated with a kappa light chain in immunofixation suggesting a myelomatous pleural effusion (MPE).
case_images: The pleural guided biopsy smear with immunofixation showed abnormal plasma cells with an intense positive CD138 staining (C) and a light kappa chain (D).
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case_images: The histological examination of the pleural guided biopsy smear showed an abnormal round cell tumor ( Figure 5), with an intense and diffuse positive staining for CD138 and MUM1 ( Figure 6), associated with a kappa light chain in immunofixation suggesting a myelomatous pleural effusion (MPE).