• Tiantian Cen, Qiaoli Zhang, Yanan Ying, Zhongbo Chen, Xiaoqun Zhang, Xiao Wu, Qian Deng, Gun Chen, Fengyun Tao, Peipei Ye, and Hongying Ma.
• Department of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China.
• Medicine (Baltimore). 2024 Jun 14; 103 (24): e38406e38406.

RationalePleural effusion, especially bilateral bloody pleural effusion, is a rare complication of Waldenström macroglobulinemia (WM). Pleural effusion in patients with WM has many causes, such as infection, tumor invasion of the pleura, and rupture of the thoracic duct or its branches. Patients with WM presenting to the respiratory department with chest tightness and shortness of breath need more differential diagnosis by respiratory physicians, which is helpful for effective treatment. Herein, we present a case of MV diagnosis in a patient with bilateral bloody pleural effusion.Patient ConcernOur patient is a 59-year-old man with WM presenting as having bilateral bloody pleural effusion.InterventionsThe patient was treated with pleural effusion drainage. After confirming the diagnosis, the patient was treated with rituximab, cyclophosphamide, and dexamethasone.OutcomesFollowing these treatments, the patient's symptoms improved, and ultrasound showed a decrease in pleural effusion.LessonsDespite its favorable prognosis, the cause of pleural effusion in a patient with WM can be challenging to diagnose. The cause of pleural effusion should be considered a differential diagnosis when diagnosing patients diagnosed with WM.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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