A case of multiple myeloma with massive pleural effusion is reported. A 53 year-old previous known multiple myeloma patient vistited our hospital complaining of cough with sputum. Radiologic study revealed multiple osteolytic bony lesions and left side pleural effusion. The effusion were bloody exudates containing numerous atypical plasma cells. The tumor cells showed pleomorphism, eccentric nuclei, prominent nucleoli, perinuclear halo, multincleation, and chromatin patterns of occasional cart-wheel appearance. The cytological examination of pleural fluid established the malignant nature of the effusion with multiple myeloma.
Biopsy* ; Chromatin ; Cough ; Enzyme Assays* ; Exudates and Transudates ; Glycogen Storage Disease* ; Glycogen* ; Humans ; Lung ; Lymphoma, T-Cell, Peripheral ; Middle Aged ; Multiple Myeloma ; Plasma Cells ; Pleural Effusion ; Sputum

The diagnosis of peripheral T cell lymphoma is difficult due to the varying size and shape of the neoplastic lymphoid cells and the frequent admixture of nonneoplastic mature lymphyocytes, histiocytes, eosinophils, and plasma cells. We report a case of peripheral T cell lymphoma, lymphoepithelioid cell type, which was difficult to differentiate from tuberculous lymphadenitis due to the aggregates of epithelioid histiocytes mimicking granuloma and the past history of pulmonary tuberculosis. Fine needle aspiration cytology of the inguinal lymph node in a 63-year-old male was characterized by hypercellular aspirates composed of a mixture of small and intermediate-size lymphoid cells and large lymphoid cells with background of confluent epithelioid histiocytes. The neoplastic lymphocytes demonstrated significant nuclear irregularity with protrusion and indentations of the nuclear membrane, prominent nucleoli, and frequent mitotic figures. The diagnosis of peripheral T cell lymphoma was confirmed by histological and immunohistochemical studies.
Biopsy, Fine-Needle ; Carcinoma, Acinar Cell ; Diagnosis ; Eosinophils ; Glomerulonephritis* ; Granuloma ; Histiocytes ; Humans ; Lymph Nodes ; Lymphocytes ; Lymphoma, T-Cell, Peripheral ; Male ; Middle Aged ; Nephrotic Syndrome* ; Nuclear Envelope ; Parotid Gland ; Plasma Cells ; Tuberculosis, Lymph Node ; Tuberculosis, Pulmonary