Waldenström macroglobulinemia presenting as bilateral bloody pleural effusion: A case report

Rationale:Pleural effusion, especially bilateral bloody pleural effusion, is a rare complication of Waldenstr & ouml;m macroglobulinemia (WM). Pleural effusion in patients with WM has many causes, such as infection, tumor invasion of the pleura, and rupture of the thoracic duct or its branches. Patients with WM presenting to the respiratory department with chest tightness and shortness of breath need more differential diagnosis by respiratory physicians, which is helpful for effective treatment. Herein, we present a case of MV diagnosis in a patient with bilateral bloody pleural effusion.Patient concern:Our patient is a 59-year-old man with WM presenting as having bilateral bloody pleural effusion.Interventions:The patient was treated with pleural effusion drainage. After confirming the diagnosis, the patient was treated with rituximab, cyclophosphamide, and dexamethasone.Outcomes:Following these treatments, the patient's symptoms improved, and ultrasound showed a decrease in pleural effusion.Lessons:Despite its favorable prognosis, the cause of pleural effusion in a patient with WM can be challenging to diagnose. The cause of pleural effusion should be considered a differential diagnosis when diagnosing patients diagnosed with WM.