A patient with multiple myeloma and respiratory insufficiency due to accumulation of paraprotein in the alveolar space

Summary We describe a patient with multiple myeloma and respiratory insufficiency. Autopsy revealsed acumulation of igG-kappa paraprotein in the alveolar space. The clinical and pathological presentation are typical for secondary pulmonary alveolar proteinosis. Attention is focussed on the possibility of secondary pulmonary alveolar proteinosis as cause for dyspnoea in patients with haematological malignancies.