This case is presented with a pulmonary parenchymal destruction due to acquired multiple myeloma who has a history of pulmonary tuberculosis. A 55 year old male patient attempted to emergency department with complaints of shortness of breath. The final diagnose with the existing clinical and laboratory outputs were right pulmonary parenchymal destruction and pleural involvements secondary to multiple myeloma. Our prediagnose was confirmed by the overt plasma cell increase and Russell bodies in cytopathologic examination of the pleural fluid. Even though multiple myeloma leads to destruction in the pulmonary parenchyma rarely, patients should be scrutinized enough to elicit true diagnose.