PMC8403078_01
Changes in chest CT findings during the course of the disease. (A) Taken on 8 June 2020, Initial stage: Chest CT showed bilateral pleural effusion as well as left interlobar effusion and no manifestation of acute inflammation and space-occupying lesions. (B) Taken on 15 July 2020, Remission stage: slowly increasing tendency of the left pleural effusion and no increasing in right pleural effusion. (C) Taken on 17 August 2020, Relapse stage: obvious increase of left pleural effusion and decrease of right pleural effusion. (D) Taken on 3 September 2020, Terminal stage: Ground-glass opacity and consolidation in the right lung, diffuse ground-glass opacity in the left lung, the progression of lesions in upper lobe and decrease of bilateral pleural effusion.
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In June 2020, the patient developed bilateral pleural effusion when the frequency of daratumumab was reduced (Figure 1A, June 8, 2020, chest Computerized Tomography (CT)). As a result, the left-sided pleural effusion began to increase slowly (Figure 1B: July 15, 2020, chest CT). CT (Figure 1C, August 17, 2020) signifying the obvious increase of left-sided pleural effusion. Again, a microbiological examination of left-sided effusion found no pathogens. Cytological analysis and flow cytometry analysis revealed a large number of abnormal plasma cells. Chest CT was examined in September (Figure 1D, September 3, 2020), disclosing ground-glass opacity and consolidation in the right lung, diffuse ground-glass opacity in the left lung, the progression of lesions in upper lobe and decrease of bilateral pleural effusion.