Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0026764 (multiple myeloma)
 36,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Histiocytic lymphoma of the ileocecal region developed in a patient with multiple myeloma following successful long-term alkylating agent therapy. Five and one-half years after the diagnosis of myeloma, while in remission on cyclophosphamide therapy, the patient experienced severe abdominal right lower quadrant pain due to a large cecal lymphoma. A right hemicolectomy was performed with relief of symptoms. However, 9 months later, while still asymptomatic, routine physical examination revealed a recurrent right lower quadrant tumor. Radiation therapy decreased the size of the mass, but five months later partial small bowel obstruction occurred because of recurrent lymphomatous infiltration. The patient died 7 years after the diagnosis of myeloma with extensive abdominal lymphoma. There was no evidence of recurrent myeloma after the initial remission on cyclophosphamide therapy. This patient adds to the growing literature of a second malignancy occurring after prolonged successful chemotherapy of a primary neoplasm.
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PMID:Histiocytic lymphoma of the ileocecal region after chemotherapy for multiple myeloma. 36 75

Extramedullary plasmacytoma (EMP), being different from multiple myeloma, is very rare. One case of primary EMP of small intestine and review of literature are presented. The patient, 69-year-old male, was admitted because of left lower abdominal pain and anemia. A mass, table-tennis in size, was palpated. Intestinal obstruction was found by plain X-ray film. It was diagnosed as EMP of small intestine by pathology after exploratory celiotomy. Immunohistochemical stain showed that intracytoplasmic immunoglobulin was monoclonal IgG. Lambda. The blood Bence-Jones protein and bone marrow puncture were negative. The patient received chemotherapy after operation and was followed for two years giving satisfactory result. The pathogenesis, clinical feature, diagnostic criteria and treatment are discussed.
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PMID:[Extramedullary plasmacytoma of small intestine--a case report]. 324 6

A 55 year old woman with multiple myeloma presented with a pathological fracture of the right neck of femur. Following internal fixation, and during subsequent radiotherapy, she developed small bowel obstruction. Laparotomy revealed an intussusception about a small bowel myeloma deposit. This is a previously unreported cause of small bowel intussusception.
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PMID:Multiple myelomatosis: an unusual cause of small bowel intussusception. 362 51

A patient with IgA-k multiple myeloma is presented. There was initially a good response to chemotherapy but the patient later developed small intestinal obstruction. This was due to multiple polypoid plasmacytomas. The mesenteric nodes were also involved, and were found on immunofluorescence microscopy and flow cytometry with double fluorescent labelling to be composed of two separate populations of cells (IgA-k and IgG-k), one population having a diploid content of DNA and the other tetraploid. These two distinct cell populations differed in both proliferative characteristics and size. The findings are discussed and the literature relating to gastrointestinal involvement in plasma cell dyscrasias reviewed.
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PMID:Gastrointestinal involvement with myeloma. 688 26

Extramedullary plasmacytoma (EMP) of the small bowel is a rare entity previously reported as a cause of intestinal obstruction or bleeding. A case report of this disease entity presenting as an ileocolic fistula is reported. EMP is diagnosed by the following criteria: 1) absence of paraproteinemia; 2) absence of Bence Jones proteinuria; 3) normal skeletal survey; and 4) normal bone marrow biopsy specimen. Gastrointestinal plasmacytoma often occurs as a manifestation of multiple myeloma. EMP of the gastrointestinal tract is a rare manifestation of the disease, accounting for 13 per cent of all cases of EMP. It is a slow-spreading, radiosensitive tumor with a high tendency toward local recurrence. Surgical excision combined with radiotherapy is the treatment of choice for EMP of the gastrointestinal tract.
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PMID:Extramedullary plasmacytoma of the small intestine: first case report of ileocolic fistula and review of the literature. 731 32

Amyloidosis is a well known complication of Multiple Myeloma. Although involvement of the gastrointestinal tract is common in patients with Amyloid, severe symptoms are no frequent, nevertheless vascular deposits may produce gastrointestinal ischemia and bleeding and perforation. Injured mucosae of the intestinal well may produce malabsorption and the neuromuscular infiltration determine alterations of gastrointestinal motility. Although renal and cardiac disfunction is the most frequently cause of death in these patients, intestinal pseudo-obstruction bears a serious prognosis. We present a case of a patients who was operated because of a presumptive diagnosis of intestinal obstruction, which small bowel was infiltrated with Amyloid and which bone marrow demonstrated multiple myeloma.
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PMID:[Amyloid intestinal pseudo-obstruction as initial manifestation of IgA multiple myeloma]. 754 45

We report a rare case of extramedullary plasmacytoma, which arose either in the ileum or the ileal mesentery. A 70-year-old woman presented with a high fever and symptoms of bowel obstruction. Computed tomography and magnetic resonance imaging showed a large heterogeneous tumor in the peritoneal cavity. Serum immunoelectrophoresis revealed a biclonal increase of IgA-Kappa and IgG-Kappa. At surgery, we found that the parenchyma of the fragile tumor had firm communication with the ileal mesentery, and the cavity of the tumor communicated with the ileal lumen. After a temporary regression following surgery and chemotherapy, the tumor grew rapidly. Although there was no evidence of progression to multiple myeloma, the patient died of cachexia less than 4 months after surgery.
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PMID:Biclonal extramedullary plasmacytoma arising in the peritoneal cavity: report of a case. 1505 59

The purpose of this study is to assess the impact on clinical decision making of chest computed tomography (CT) in immunocompetent emergency department (ED) patients with chest radiographic (CXR) findings of pneumonia. We retrospectively identified 1,373 patients from our ED who underwent chest CT between 7/05 and 6/06. Report of CXR within 24 h before CT were reviewed to identify patients with findings of pneumonia. The following were the exclusion criteria: recommendation of CT on CXR report and immunocompromised status on chart review. Fifty-one patients met the inclusion criteria: 26 women and 25 men, with a mean age of 60 (range 29-103) years. Age- and sex-matched controls from the ED with CXR findings of pneumonia who did not undergo CT were identified. Charts were reviewed for clinical presentation, management, and follow-up. Patient and control groups were compared using Fisher exact and paired Student's t tests. The patients were sicker than the controls with more signs and symptoms including auscultation abnormalities, 64 (33 of 51) vs 47% (24 of 51), abnormal sputum 32 (16 of 51) vs 0%, hypoxemia 22 (11 of 51) vs 2% (1 of 51), weight loss, 20 (10 of 51) vs 4% (2 of 51), and night sweats, 16 (8 of 51) vs 2% (1 of 51; p < 0.05 each). Clinical management, (based on CT findings in 31% [16 of 51]), was more extensive for patients than controls: antibiotics initiated 82 (41 of 51) vs 47% (24 of 51), antibiotics changed 29 (15 of 31) vs 0%, procedures performed 24 (12 of 51) vs 0%, and mean length of stay was 8 days vs less than 1 (p < 0.05, each). Sixteen percent (8 of 51) of the patients had alternative/additional diagnosis based on CT: pulmonary embolism, lung cancer, hypersensitivity pneumonitis, multiple myeloma, renal cell carcinoma, small bowel obstruction, lung nodule, and endobronchial mass (n = 1, each). Eight percent (4 of 51) of the patients and no controls were diagnosed with tuberculosis (p = 0.06). Immunocompetent ED patients with CXR findings of pneumonia who underwent chest CT were sicker than those who were not imaged with CT. Chest CT was often useful in guiding therapy or providing an alternative diagnosis.
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PMID:Impact of chest CT on the clinical management of immunocompetent emergency department patients with chest radiographic findings of pneumonia. 1770 Dec 35

We report the case of a 59-year-old Afro-Caribbean woman who presented with symptoms of anorexia, lethargy, abdominal distension and vomiting on the background of newly diagnosed multiple myeloma, treated with one cycle of cyclophosphamide-thalidomide-dexamethasone chemotherapy 20 days previously. A diagnosis of subacute bowel obstruction was made; however, the aetiology of the obstruction remained elusive. Common electrolyte abnormalities were excluded and a midline laparotomy revealed minimal intra-abdominal adhesions. Histological examination of a small bowel mesentery biopsy showed inflammatory cell infiltrate composed of lymphocytes, eosinophils and occasional plasma cells with a foreign body giant cell reaction suggestive of worm infection. A postoperative stool sample revealed heavy infestation with the rhabditiform larvae of Strongyloides stercoralis. The patient recovered following ivermectin treatment. In the absence of other causality, we attribute the subacute bowel obstruction to S stercoralis hyperinfection, triggered by immunosuppression secondary to chemotherapy and multiple myeloma.
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PMID:Strongyloides stercoralis hyperinfection presenting as subacute small bowel obstruction following immunosuppressive chemotherapy for multiple myeloma. 2446 40

There are two major forms of amyloidosis, primary amyloidosis (AL) and secondary amyloidosis. AL amyloidosis results from deposition of immunoglobulin light chains or their fragments. One such example is AL amyloidosis associated with multiple myeloma, in which overproduced immunoglobulin light chains get deposited onto tissues, leading to tissue dysfunction. Amyloidosis in the intestines can present as a wide spectrum of non-specific gastrointestinal (GI) complaints including abdominal pain, changes in bowel habits, overt gastrointestinal bleeding and complaints related to altered motility in over 95% of the patients. In our case report, we describe a 70-year-old male taken to the operating room (OR) for non-resolving small bowel obstruction, found to have pseudo-obstruction and hemorrhagic enteritis. He was also diagnosed with multiple myeloma from a bone marrow biopsy and later biopsy of stomach and duodenum revealed amyloid deposition consistent with amyloidosis. In conclusion, patients with multiple myeloma and vague abdominal complaints should raise suspicion of amyloidosis.
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PMID:Systemic amyloidosis causing intestinal hemorrhage and pseudo-obstruction. 2521 Jan 37


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