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<article article-type="case-report" dtd-version="1.0" xml:lang="en" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">kjh</journal-id>
<journal-title-group>
<journal-title>The Korean Journal of Hematology</journal-title>
<abbrev-journal-title>Korean J Hematol</abbrev-journal-title>
</journal-title-group>
<issn pub-type="ppub">1738-7949</issn>
<issn pub-type="epub">2092-9129</issn>
<publisher>
<publisher-name>Korean Society of Hematology</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.5045/kjh.2005.40.4.261</article-id>
<article-id pub-id-type="publisher-id">kjh-40-261</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Case Report</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>A Case of Multiple Myeloma Presenting as Non-obstructive Jaundice Due to Plasma Cell Infiltration of the Liver</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name name-style="western" xml:lang="en">
<surname>Yu</surname> <given-names>Mi-Hyun</given-names></name> <degrees>M.D.</degrees>
<xref ref-type="aff" rid="aff1-kjh-40-261"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author">
<name name-style="western" xml:lang="en">
<surname>Kim</surname> <given-names>Hyun-Woo</given-names></name> <degrees>M.D.</degrees>
<xref ref-type="aff" rid="aff1-kjh-40-261"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author">
<name name-style="western" xml:lang="en">
<surname>Yeo</surname> <given-names>Young-Sun</given-names></name> <degrees>M.D.</degrees>
<xref ref-type="aff" rid="aff1-kjh-40-261"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author">
<name name-style="western" xml:lang="en">
<surname>Lim</surname> <given-names>Jeong-Woo</given-names></name> <degrees>M.D.</degrees>
<xref ref-type="aff" rid="aff1-kjh-40-261"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author">
<name name-style="western" xml:lang="en">
<surname>Jeong</surname> <given-names>Woo-Jin</given-names></name> <degrees>M.D.</degrees>
<xref ref-type="aff" rid="aff1-kjh-40-261"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author">
<name name-style="western" xml:lang="en">
<surname>Han</surname> <given-names>Eun-Mee</given-names></name> <degrees>M.D.</degrees>
<xref ref-type="aff" rid="aff2-kjh-40-261"><sup>2</sup></xref>
</contrib>
<contrib contrib-type="author">
<name name-style="western" xml:lang="en">
<surname>Seo</surname> <given-names>Chul-Won</given-names></name> <degrees>M.D.</degrees>
<xref ref-type="aff" rid="aff1-kjh-40-261"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author">
<name name-style="western" xml:lang="en">
<surname>Kim</surname> <given-names>Soon-Bae</given-names></name> <degrees>M.D.</degrees>
<xref ref-type="aff" rid="aff1-kjh-40-261"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author">
<name name-style="western" xml:lang="en">
<surname>Park</surname> <given-names>Su-Kil</given-names></name> <degrees>M.D.</degrees>
<xref ref-type="aff" rid="aff1-kjh-40-261"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author">
<name name-style="western" xml:lang="en">
<surname>Lee</surname> <given-names>Sang-Koo</given-names></name> <degrees>M.D.</degrees>
<xref ref-type="corresp" rid="c1-kjh-40-261"/>
<xref ref-type="aff" rid="aff1-kjh-40-261"><sup>1</sup></xref>
</contrib>
<aff id="aff1-kjh-40-261" xml:lang="en"><label>1</label>Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, <country>Korea</country></aff>
<aff id="aff2-kjh-40-261" xml:lang="en"><label>2</label>Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, <country>Korea</country></aff>
</contrib-group>
<author-notes>
<corresp id="c1-kjh-40-261">Correspondence to: Sang-Koo Lee, M.D. Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center 388-1 Pungnap-dong, Songpa-gu, Seoul 138-600, Korea Tel: &#x002B;82-2-3010-3265, Fax: &#x002B;82-2-3010-6963 E-mail: <email>sklee2@amc.seoul.kr</email></corresp>
</author-notes>
<pub-date pub-type="ppub"><month>12</month><year>2005</year></pub-date>
<pub-date pub-type="epub"><day>21</day><month>12</month><year>2005</year></pub-date>
<volume>40</volume><issue>4</issue>
<fpage>261</fpage><lpage>265</lpage>
<history>
<date date-type="received"><day>23</day><month>10</month><year>2005</year></date>
<date date-type="rev-recd"><day>28</day><month>11</month><year>2005</year></date>
<date date-type="accepted"><day>05</day><month>12</month><year>2005</year></date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2005 Korean Society of Hematology</copyright-statement>
<copyright-year>2005</copyright-year>
<license><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license>
</permissions>
<abstract xml:lang="en">
<title>Abstract</title>
<p>Extraosseous manifestations are found in less than 5% of the patients with multiple myeloma. We reported here on a rare case of multiple myeloma presenting as non-obstructive jaundice due to diffuse plasma cell infiltration of the liver. A 70-year-old man was referred to our hospital because of general weakness, weight loss, jaundice, anemia and proteinuria. The laboratory studies showed: hemoglobin 8.5g/dL, calcium 10.3mg/dL, creatinine 1.3mg/dL, AST 41IU/L, ALT 26IU/L, alkaline phosphatase 304IU/L, total bilirubin 4.0mg/dL, direct bilirubin 2.3mg/dL and 24 hour urinary protein 1,120mg. The serologic tests for hepatitis B and C virus were negative. The abdominal CT scans were normal. The urinary protein studies revealed a M component of the lamda type light chain. The bone marrow biopsy showed atypical plasma cells, and the liver biopsy showed a diffuse sinusoidal infiltration of plasma cells.</p>
</abstract>
<kwd-group xml:lang="en">
<kwd>Multiple myeloma</kwd>
<kwd>Plasma cell infiltration</kwd>
<kwd>Jaundice</kwd>
<kwd>Liver</kwd>
</kwd-group>
</article-meta>
</front>
<back>
<ref-list xml:lang="en">
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<sec sec-type="display-objects">
<title>Figures</title>
<fig id="F1-kjh-40-261" position="float">
<label>Fig. 1.</label>
<caption xml:lang="en"><p>Neoplastic plasma cells (in bone marrow) show abundant deep-blue cytoplasm with perinuclear halo (Wright-Giemsa stain, &#x00D7;1,000).</p></caption>
<graphic xlink:href="kjh-40-261f1.tif"/>
</fig>
<fig id="F2-kjh-40-261" position="float">
<label>Fig. 2.</label>
<caption xml:lang="en"><p>The infiltrated myeloma cells are seen in dilated sinusoids (H &#x0026; E stain, &#x00D7;400).</p></caption>
<graphic xlink:href="kjh-40-261f2.tif"/>
</fig>
<fig id="F3-kjh-40-261" position="float">
<label>Fig. 3.</label>
<caption xml:lang="en"><p>The immunostains for CD 138, myeloma cells show intense cytoplasmic reactivity, but surrounding hepatocytes does not (&#x00D7;400).</p></caption>
<graphic xlink:href="kjh-40-261f3.tif"/>
</fig>
</sec>
</back>
</article>