58 female right pleural effusion mild. Protein 6.2 g/dL, sugar 78, ADA 48, pale yellow clear fluid. No history available . Cytology field stain

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- Excess Of Plasma Cells In Pleural Effusion Advice - To Rule Out Reactive Causes of Plasmacellular Effusion Eg Tuberculosis ( ADA 48) - Viral Infections - Few Bacterial Infections - Connective Tiisue Disorders - History of Cardiac Surgery Neoplastic - Plasma cell Myeloma - Solitary Plasmacytoma ( chest wall) - Plasmablastic Lymphoma( Blastic population will also be see ) - Hodgkins Lymphoma Ancillary Investigations ( CRAB criteria and MDEs for myeloma ; stains AFB , Gram)

Plasmacytoid Cells Protein increased ADA increased Possibly Inflammatory condition-Kochs induced Go for CBNAAT/AFB/ESR with clinical details However in the view of plasmacytoid cells rule out Plasma cell dyscrasia

Neoplastic mononucleated bi nucleated plasma cell infiltration ... Corelation with clinical and other pathological findings to rule out plasma cell disorder.

Classical Plasma cells.few are bilnucleated. Myelomatous pleural effusion. MULTIPLE MYELOMA ( EXTRAMEDULLARY) CBC LFT RFT ALBUMIN SKELETAL SURVEY SPEP WITH IF S FREE LIGHT CHAIN ASSAY BMA BMBX CYTOGENETIC AND FISH FOR MYELOMA SOS.

Effusion contains mononucleated n binucleated rèactive mesothelial cells.imp inflamtion . DD.lymphomas.

Plasma cells, cyst macrophages. Reactive Mesothelial cells.

Smears show malignant plasma cells among lymphocytes and reactive mesothelial cells. Advised: Cell block study IHC

Reactive Mesothelial cell's

Plasma cell dyscrasia

reactive mesothelial cells

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