Metastatic Pulmonary Calcification in Multiple Myeloma: A Case Report and Review of Differential Diagnoses

Thoracic involvement in a case of multiple myeloma (MM) may occur in the form of osteolytic lesions of the skeleton, intramedullary and extramedullary plasmacytomas, pulmonary infiltrates, pleural effusion, etc. Diagnosis of pulmonary infiltrates, when present, is of critical importance in proceeding with further management. The incidence of pulmonary nodules or infiltrates in MM is 10%, which may be due to plasmacytoma, amyloidosis, metastatic pulmonary calcification (MPC), infections, etc., However, the exact incidence of MPC in MM is unknown, with lesser than 10 published case reports of the same. Here, we report an interesting case of MM with bilateral pulmonary nodules showing calcification, methodical evaluation, diagnosis, and management of the same with elaborate discussion of the differential diagnoses. This report highlights the need for evaluation of calcific pulmonary lesions in MM, their prognostic significance, and the reversible nature of MPC in MM.