Pleural amyloidosis attesting to generalised amyloidosis

During the course of generalised amyloidosis, pulmonary diseases are mainly represented by tracheobronchial involvement and diffuse or nodular parenchymal localizations. The authors report the case of a 61-year-old woman presenting exudative pleural effusion. The diagnosis of generalised amyloidosis in association with multiple myeloma with cardiac and renal involvement was established. A thoracoscopy performed during the investigation of the pleural effusion and the biopsy revealed amyloid deposits in the pleura. The patient died although melphalan/prednisone treatment was initiated. Pleural involvement in amyloidosis is without doubt under-estimated and plays a central role in the creation and persistence of pleural effusion.