Polyneuropathy organomegaly endocrinopathy M-protein and skin changes syndrome with ascites as an early-stage manifestation: A case report

Figure 1 Images from chest and abdominal computed tomography performed on the patient for the first time on March 16, 2021. A: Inflammatory lesions in the lingual segment of the left lung and lower lobes of both lungs and slightly thickened bilateral pleura and a small amount of effusion in the left pleural cavity; B: Slight enlargement of the heart and enlarged lymph nodes in the mediastinum; C: Enlarged lymph nodes in the bilateral axilla; D: Widened liver fissure and abdominal hydrops; E: Splenomegaly, pelvic hydrops, swollen and thick intestinal walls, and blurred fat space in the abdominal and pelvic cavity.

Figure 2 Pathology results. A: The liver biopsy. Punctate necrosis and old bridging necrosis in the liver parenchyma and a small amount of eosinophilic infiltration in the portal area; B: The peritoneal biopsy. Inflammatory cell infiltration in fibro-adipose tissue and proliferation of small blood vessels, indicating inflammatory lesions.

Figure 3 Images from chest and abdomen computed tomography on November 12, 2021. A: Bilateral pleural effusion and atelectasis in the bilateral lower lobes of the lungs, enlarged heart, and small amount of pericardial effusion; B: Multiple inflammatory lesions in both lungs, slightly thickened bilateral pleura, and a small amount of effusion in the left lobar fissure; C: Enlarged lymph nodes in the bilateral axilla; D: Hepatomegaly, ascites, splenomegaly, and a small cyst in the left lateral lobe of the liver; E: Enlarged retroperitoneal lymph node and thickened perirenal fascia; F: Abdominal and pelvic effusion, thickened gastrointestinal wall, and blurred fat space in the abdominal and pelvic cavity; G: Enlarged bilateral inguinal lymph nodes and edema of soft tissues in the waist, abdomen, and buttocks.

Figure 4 Images from chest computed tomography before chemotherapy treatment on December 2, 2021. A: Aggravated scattered multiple flakes and streaks in lungs considered as inflammatory changes; B: Decreased bilateral pleural effusion and increased pericardial effusion.