Shortness of breath and diffuse chest pain

Plasma cell leukemia presenting as organizing pneumonia refractory to high-dose steroid therapy

A case of steroid-refractory organizing pneumonia (OP) as the initial presentation of plasma cell leukemia (PCL) in a patient who had no prior exposure to chemotherapy or radiation is described. Since OP is traditionally a steroid-responsive disease, this case raises the possibility of a previously unknown patient subgroup with variable disease pattern and/or behavior in patients with plasma cell neoplasm.

Acute respiratory distress syndrome due to pulmonary involvement by neoplastic plasma cells in multiple myeloma

Pulmonary involvement with multiple myeloma occurs infrequently and may be difficult to distinguish from more common primary lung tumours, metastatic disease, or other pleural and parenchymal abnormalities. A patient who developed acute respiratory distress syndrome (ARDS) was subsequently found to have multiple myeloma with involvement of lung parenchyma by neoplastic plasma cells. Only one other report of ARDS in association with multiple myeloma was found, and there are no previous reports where the appearance of ARDS antedated a diagnosis of multiple myeloma. In patients with ARDS, parenchymal involvement from multiple myeloma should be included in the differential diagnosis.