Journal List > Korean J Hematol > v.40(4) > 1032641

Yu, Kim, Yeo, Lim, Jeong, Han, Seo, Kim, Park, and Lee: A Case of Multiple Myeloma Presenting as Non-obstructive Jaundice Due to Plasma Cell Infiltration of the Liver

Abstract

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.

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Fig. 1.
Neoplastic plasma cells (in bone marrow) show abundant deep-blue cytoplasm with perinuclear halo (Wright-Giemsa stain, ×1,000).
kjh-40-261f1.tif
Fig. 2.
The infiltrated myeloma cells are seen in dilated sinusoids (H & E stain, ×400).
kjh-40-261f2.tif
Fig. 3.
The immunostains for CD 138, myeloma cells show intense cytoplasmic reactivity, but surrounding hepatocytes does not (×400).
kjh-40-261f3.tif
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