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Query: UMLS:C0026764 (multiple myeloma)
 36,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 52 year old man presented with multiple myeloma and widespread amyloidosis involving joints, bursae- carpal tunnels, lymph nodes and subcutaneous tissue. Osteolytic bone lesions and pathologic fracture of the neck of the left femur were found. Bone marrow was infiltrated with both plasmacytes and lymphocytes. The majority of plasma cells contained large cytoplasmic vacuoles. Free kappa II type light chains and mu-heavy chain fragment were detected in the serum, and kappa II type Bence Jones protein was found in the urine. The molecular weight of the mu-heavy chain fragment was found to be approximately 50,000 daltons. An immunofluorescence study, using the double labelling technic, showed that the majority of plasmacytes in bone marrow contained both mu and kappa antigenic determinants in the cytoplasm. A review of the 12 previously described patients with mu-heavy chain fragment in the serum showed a variable clinical picture, thus their natural history and therapeutic response are difficult to evaluate at the present time. It seems that mu-heavy chain fragment can be found in a variety of clinical conditions and that mu-heavy chain disease cannot yet be accepted as a separate clinical entity.
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PMID:Multiple myeloma (light chain disease) with rheumatoid-like amyloid arthropathy and mu-heavy chain fragment in the serum. 9 35

A case of multiple myeloma was reported in which the initial symptom was pain and dysfunction of the TMJ that resulted from pathological fracture of the mandibular condyle. An initial radiographic skeletal survey showed no evidence of further lesions, although hematological and biochemical tests indicated a diagnosis of multiple myeloma. Treatment resulted in improvement of symptoms and of an evident regression of the lesion after 18 months. After a year, however, radiographs disclosed generalized skeletal involvement; deterioration of the general condition followed.
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PMID:Multiple myeloma involving the temporomandibular joint: report of case. 27 46

Recent reviews separate four types of plasma cell tumor: multiple myeloma, extramedullary plasmacytoma (without multiple myeloma), solitary myeloma of bone, and plasma cell leukemia. Cutaneous plasma cell tumors may arise from lymphatic or vascular spread of tumor (metastatic cutaneous plasmacytoma) or by direct extension from bone lesions. The former, metastatic cutaneous plasmacytomas, are quite rare. Specific malignant plasmacyte cutaneous tumors can also be seen in extramedullary plasmacytoma, solitary myeloma of bone, and plasma cell leukemia. We present a patient with multiple myeloma and lymphedema of the right arm, who developed a pathologic fracture of the right humerus and subsequently developed numerous metastatic cutaneous plasmacytomas localized to the lymphedematous arm. Direct immunofluorescence of frozen sections and enzymatically released cells from tumor nodule failed to reveal cell-associated immunoglobulins.
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PMID:Cutaneous plasmacytomas. A review and presentation of an unusual case. 38 25

Amyloidosis primarily involving bone is described in a 59-year-old male pateint. Well circumscribed lytic lesions of the skeleton raised the possibility of myelomatosis. The prolonged insidious course of the disease was uncomplicated by hypercalcemia, pathological fracture, or hematologic abnormalities. The clinical course, together with histological findings and strongly positive bone scan, were the distinguishing features. The osseous manifestations without plasma cell tumor appears to be a rare occurrence in amyloidosis.
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PMID:Bone lesions in primary amyloidosis. 50 49

A patient with a previously diagnosed case of multiple myeloma was readmitted for a pathologic fracture of the hip. Intraoral examination revealed a soft-tissue swelling over the right posterior mandibular ridge. Radiographs showed multiple radiolucent areas of the maxilla and mandible. A needle-biopsy technique was used to confirm the diagnosis of intraoral manifestations of plasma-cell myeloma.
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PMID:Intraoral corroboration of systemic plasma-cell myeloma. Abbreviated case report. 106 38

Intermittent courses of dexamethasone (DEX) were administered to 112 consecutive, previously untreated patients with multiple myeloma (MM). Using criteria based on a 75% or greater reduction of calculated tumor mass, the overall response rate was 43%. Among comparable patients, response rate were approximately 15% less than those observed previously with vincristine-doxorubicin by continuous infusion with intermittent DEX (VAD) and similar to those with melphalan-prednisone. The projected survival times with VAD or DEX were similar. Results indicated that DEX accounted for most of the plasma cell reduction achieved with VAD. Serious complications occurred in 27% of patients treated with VAD, but in only 4% of those who received DEX. In view of the similar outcome with fewer serious complications, DEX provided a simple, effective, and safe primary treatment for a large fraction of patients with MM. Patients who appear most likely to benefit include those with hypercalcemia or pancytopenia, or who require simultaneous radiotherapy for a pathologic fracture.
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PMID:Primary dexamethasone treatment of multiple myeloma. 149 31

There is a wide spectrum of disease among patients with plasma cell myeloma. A small fraction have a localized plasmacytoma of bone that requires specialized techniques for accurate staging, followed by local radiotherapy that may be curative in some patients. Other patients with multiple myeloma may be free of symptoms and the disease is recognized by chance laboratory studies. Some have a prolonged, stable course with little change in disease for many months or years and resemble patients with MGUS. These patients have low serum myeloma protein and are free of focal bone lesions even on MR imaging. Complications are more imminent among other patients with higher levels of myeloma protein and/or bone lesions, who usually require treatment within 2 years after diagnosis. Still other patients with more advanced generalized disease (intermediate tumor mass) or with a pathologic fracture that may be relieved with local radiotherapy usually require even earlier chemotherapy to prevent or treat complications.
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PMID:Solitary plasmacytoma of bone and asymptomatic multiple myeloma. 158 78

A 57-year-old man was followed up for multiple myeloma with no lytic bone lesions. During a septicaema, he presented with a pathological fracture of the patella. Despite a poor haematological status, he received surgical treatment, which allowed diagnosis of haematogenous osteomyelitis of the patella. The outcome was favourable, with a 6-week plaster immobilization after cerclage and 4 months of intravenous antibiotic therapy. This case emphasizes the fact that one well-known cause of bone lesions may lead to an erroneous diagnosis. The successful clinical course suggests that accurate therapeutic management may be discussed in haematological malignancies when intensive-care support is available.
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PMID:Acute haematogenous osteomyelitis of the patella revealed by a pathological fracture in multiple myeloma. 173 5

A 58-year-old female was admitted to our hospital because of anemia in March 1987. Monoclonal protein (IgA, kappa) was detected and a diagnosis of multiple myeloma was made. Partial remission was obtained after VAD therapy with alpha-interferon. In December 1989, she was readmitted because of a pathological fracture of the left humerus. A white blood cell count was 4400/microliters with 30% myeloma cells and the urine protein (Bence Jones protein) was 26 g/day. Systemic chemotherapy was not effective. She developed pleural and pericardial effusions, bone mass, disturbance of consciousness and died of respiratory failure only 3 months after readmission. The pleural and pericardial fluids contained many myeloma cells. c-myc gene rearrangement was detected in myeloma cells obtained from the pleural fluid using c-myc exon1 and exon2 probes. The levels of interleukin-6 (IL-6) measured by ELISA was 107.4 pg/ml in serum, 56.2 pg/ml in pleural fluid and 780.0 pg/ml in pericardial fluid. Because of the lack of any overt infectious focus, the level of IL-6 appears to have been related to aggressive proliferation of myeloma cells. It was of interest that C-reactive protein, induced by IL-6, was a good marker reflecting disease activity.
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PMID:[A high serum level of interleukin-6 in a patient with aggressive multiple myeloma]. 175 53

Inclusions in the nucleus, compared with those in the cytoplasm, are rare in myeloma cells but have been reported in all electrophoretic varieties of multiple myeloma except the nonsecretory type. In this unusual case, a 54 year old Chinese woman had a pathological fracture of the left femur, and biopsy of the fracture site revealed a round cell tumor compatible with plasmacytoma. A bone marrow aspirate revealed 50% plasma cells, many of which contained intranuclear inclusions. Protein electrophoresis was normal with no paraprotein, and urine was free from Bence-Jones protein. Under electron microscopy, the plasma cells showed electron-dense spherules not circumscribed by a membrane. The absence of a membrane was unusual, because according to all reported cases, these intranuclear inclusions were invariably membrane-bound. The association of nonsecretion of paraprotein in myeloma, which is rare, and the absence of a membrane enclosing the intranuclear inclusions, which is heretofore unreported, is probably not coincidental but causally related in that paraprotein produced in the nucleus of myeloma cells (stored in the form of intranuclear inclusions) fails to be detected in serum and urine because of noninteraction between these inclusions and the membranes of the nucleus and endoplasmic reticulum.
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PMID:Intranuclear inclusions in myeloma cells in a case of nonsecretory multiple myeloma. 217 3


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