An elderly man, with no comorbidity, presented with rapidly accumulating left pleural effusion. He also had generalized adenopathy. Pleural fluid cytology showed exudative pleural effusion with eosinophilia. Supraclavicular lymph node biopsy was reported as amyloid. On further investigation he was found to have kappa-light chain multiple myeloma. The final diagnosis was eosinophilic pleural effusion in a patient with multiple myeloma.
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