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Background

Multiple myeloma (MM) is a hematologic malignancy of plasma cell origin. MM primarily affects bone marrow, but extramedullary sites can also be involved. Myelomatous pleural effusion (MPE) is an atypical and rare complication of MM. We aimed to systematically study the incidence and clinicopathologic profile of patients with MPE in a real-world setting.

Patients and Methods

In this retrospective study, 415 consecutive patients with MM managed at a tertiary care center in North India during a study period of January 1, 2010 to December 31, 2015 were evaluated for MPE. The patients with MPE were analyzed for their clinical profile, diagnosis, treatment, and outcomes.

Results

Of these 415 patients, 11 (2.65%) patients had MPE. The median age of the study population was 50 years with male preponderance. The majority of these patients had immunoglobin (Ig)G Kappa disease. All patients had higher than International Staging System stage I disease. MPE was a presenting feature at MM diagnosis in 45.45% (n = 5) of the patients, whereas the rest developed MPE during follow-up. MPE presented predominantly (81.8%) as a unilateral effusion. Concurrent extramedullary involvement at other site was seen in 45.45% (n = 5), with 3 (27%) patients having concurrent myelomatous ascites. Six of these were managed aggressively, whereas 5 patients opted for palliation. The outcomes were dismal (90.9% mortality), with a median survival of 2.47 months.

Conclusion

MPE is a rare entity, and positive outcomes of therapy remain low with dismal prognosis.  相似文献   
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A sublethal concentration of technical grade endosulfan (END) inhibited 35 to 55% of the activities of cytoplasmic malate dehydrogenase (cMDH), mitochondrial malate dehydrogenase (mMDH), and lactate dehydrogenase (LDH) in the liver and the skeletal muscle of a freshwater catfish, Clarias batrachus, after 7 days of exposure. The activity remained in the inhibited state up to 28 days. The withdrawal of END from the medium after 1 week of exposure gradually restored the activities to control levels within 21 days in the skeletal muscle and 28 days in the liver. The administration of actinomycin D or cycloheximide between the 14th and the 21st day of the withdrawal of END almost completely inhibited the withdrawal-dependent recovery in the activities of all the three enzymes. This indicates de novo synthesis of the enzymes during the recovery period. A conjoint treatment of END and triiodothyronine (T3) raised the activities of cMDH, mMDH, and LDH in the liver and the skeletal muscle up to the control levels. This shows that the inhibitory effect of END may be relieved in presence of T3. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed few changes in the pattern of cytoplasmic proteins of the liver and the skeletal muscle in response to exposure to END.  相似文献   
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Ten smoker sportsmen and 17 non-smoker sportsmen and 41 smoker non-sportsmen were studied. Lung function was assessed by means of Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), the ratio of FEV1 to FVC (FEV1%) and Peak Expiratory Flow Rate (PEFR). For the smokers, all the tests were conducted before smoking (BS) and 30 min after smoking (AS) two cigarettes consecutively to observe the acute effect of smoking. In the smoker sportsmen there was no significant difference between BS and AS measures of lung function. Before smoking smoker sportsmen had lower values for FEV1, FEV1% and PEFR than non-smoker sportsmen (p less than 0.05). However, smoker sportsmen show higher BS values of FEV1 (p less than 0.01), FEV1% (p less than 0.01) and PEFR (p less than 0.05) compared with those of smoker non-sportsmen who had similar smoking indices. These results indicated that the smoker sportsmen, despite exhibiting some degree of lung function impairment in relation to non-smoker sportsmen, still maintained rather better lung function status than the smoker non-sportsmen.  相似文献   
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Mice were fed for 24 weeks with three different subtoxic dosages of γ-HCH (0.012, 0.12 and 1.2 mg/kg) mixed in powdered feed. The immunological profile was assessed at an interval of one month during the entire exposure period. Both the cell mediated and humoral components of immunity showed a biphasic response characterized initially by stimulation followed by suppression in a dose dependent manner. However, γ-HCH did not affect the functional properties of peritoneal macrophages. Histological changes in lymphoid organs were in accordance with the biphasic immunomodulatory effects of γ -HCH.  相似文献   
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A case of veruccous carcinoma of the maxilla extending to alveulus and palate is reported. Treated with radical maxillectomy: there has been no recurrence within one year. The coexistance of submicous fibrosis and veruccous carcinoma is observed and the histological features of the later are highlighted.  相似文献   
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