Journal List > Korean J Hematol > v.44(3) > 1032832

Jin, Baek, Song, Yun, Yang, Lee, Yun, Kim, Jo, and Kim: A Case of Multiple Myeloma Associated with Multifocal Osteosclerosis (Multiple Myeloma with Osteosclerosis)

Abstract

Osteosclerotic myeloma is a rare entity, characterized by single or multiple osteosclerotic bone lesions and usually accompanied by a polyneuropathy syndrome (POEMS). Multiple myeloma with osteosclerotic lesions without polyneuropathy is exceedingly rare. We report a case of multiple myeloma associated with multifocal osteosclerotic lesions without any evidence of POEMS. A 48-year-old woman presented with incidentally found osteosclerosis of 8th thoracic vertebra on a plain chest film. Bone survey, CT scan, MR scan, and radioisotope scintigraphy revealed multiple localized osteoclerosis; serum protein immunofixation showed IgG, lambda monoclonal gammopathy. A biopsy of T8 vertebral body disclosed plasma cell myeloma. Given that there was no organ or tissue damage other than multifocal osteosclerosis, the patient was placed on close observation with regular examination. This case indicates that although rare, multiple myeloma should be included in the differential diagnosis of sclerotic bone lesions.

References

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Fig. 1.
Plain images show multifocal bony sclerosis. (A) A thoracic spine image shows sclerotic changes in vertebral bodies (T8, L1) and coracoid process of left scapula (arrows). (B) A lumbar spine image shows osteosclerotic lesions in pelvic bone and femur (arrows).
kjh-44-188f1.tif
Fig. 2.
An abdomen CT scan image shows focal bony sclerosis in a vertebral body (arrow).
kjh-44-188f2.tif
Fig. 3.
T1-weighted MR images show osteoblastic low signal intensity lesions in the bodies of T8–10, L1, L2 and L5 vertebrae.
kjh-44-188f3.tif
Fig. 4.
Biopsy of T8 vertebral body shows focal infiltration of CD138-positive atypical plasmacytoid cells, which is consistent with plasma cell myeloma (A) HE stain, ×200. (B) Immunohistochemical stain for CD138, ×400.
kjh-44-188f4.tif
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