A case of malignant melanoma detected by a massive black pleural effusion
Yuko Usagawaa Shunji Mizunoeb Naoko Fujitaa Kenji Umekic Toru Yamasakib Jun-ichi Kadotac
aDepartment of Respiratory Medicine, Oita Kouseiren Tsurumi Hospital
bRespiratory Medicine, Oita Prefectural Hospital
cDepartment of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine
A 41-year-old woman was admitted to our hospital for evaluation of persistent cough and dyspnea. Chest X-ray and CT scan showed a right massive pleural effusion. Diagnostic thoracocentesis was performed and revealed a black pleural effusion, and its cytologic and histologic examinations showed malignant cells containing variable amounts of melanin pigment in their cytoplasm. A diagnosis of malignant melanoma with pleural metastasis was made. The effusion was drained by tube thoracostomy and chemotherapy started because of multiple metastases found by systemic evaluation, although it was ineffective. Massive pleural effusion is an infrequent presentation of metastatic malignant melanoma. Moreover, respiratory symptoms, such as the initial clinical manifestation, are rare. And even if unusual, malignant melanoma should be taken into account in the presence of a black pleural effusion.
Malignant melanoma Black pleural effusion Immunohistochemistry
Received 14 Jan 2015 / Accepted 18 May 2015
AJRS, 4(5): 361-364, 2015