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

The purpose of this paper is to present the precursors and complications of multiple myeloma as manifested in Otolaryngology. The modern Otolaryngologist is well aware that systemic disease may manifest itself in our specialty. Multiple myeloma is a distinctive form of plasma cell dyscrasia which often manifests itself in Otolaryngology. For example, patients may present with epistaxis, hoarseness, asymmetry of the face, swelling of the palate, nasal obstruction and a multiplicity of other symptoms. Therefore, the practicing Otolaryngologist must maintain a high index of suspicion that a seemingly simple sign or symptom may represent one small facet of a generalized condition. The paper emphasizes that in many instances a slight extension of our history taking may provide us with information leading to the diagnosis of this systemic disease. Cases seen by the author are reviewed and the relevant clinical features are presented.
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PMID:The otolaryngologic manifestations of multiple myeloma. 67 64

Plasmacytomas, indistinguishable histologically from plasma cell tumors arising in bone marrow, occur almost anywhere in the body-usually independently of multiple myeloma. Thus, they represent an isolated area of plasmacytic dyscrasia but occasionally can be the first evidence of multiple myeloma. From 1949 to 1974, six patients with solitary extramedullary plasmacytomas of the larynx were seen at the Mayo Clinic; during this period, approximately 3,100 patients with malignant laryngeal neoplasms were examined. For these six patients, the median age was 53 years (range, 32 to 63 years). The first symptom in five patients was hoarseness (mean duration, nine months). Excision, electrocoagulation, irradiation, or some combination of these constituted effective therapy. Follow-up ranged from 3 to 25 years. The choice of therapy depends on the size, shape, and location of the tumor. Extensive surgery is rarely necessary.
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PMID:Solitary extramedullary plasmacytoma of the larynx. 83 44

Primary localized amyloidosis was found in a family. A 66-year-old woman had suffered from hoarseness for 18 years. A biopsy specimen from the larynx showed amyloid deposits in the submucosal connective tissue. Her 40-year-old daughter noticed a subcutaneous nodule on her philtrum. Histologic examination showed the deposition of amyloid in the middle and lower dermis, which also encased the blood vessels and epidermal appendages. In both cases the amyloid deposits were positively stained with Congo red and the staining was resistant to potassium permanganate treatment. These amyloid deposits were strongly positive against the anti-amyloid antibody of the lambda light chain. These results indicate that the amyloid substance is derived from protein AL. There was no clinical or laboratory evidence of systemic amyloidosis or multiple myeloma in either patient.
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PMID:Primary localized amyloidosis in one family. 193 75

Plasmacytoma involving the larynx is very rare. To the best of our knowledge there are only 79 cases reported in the world literature. We are adding 3 more cases; 2 cases were associated with multiple myeloma and 1 was considered to be a solitary or extramedullary plasmacytoma. The clinical picture was hoarseness and upper airway obstruction. In plasmacytoma of the larynx multiple biopsies are often nondiagnostic, sometimes revealing only chronic inflammation and amyloid infiltration in the tissues. Most authors agree that the treatment of choice is conservative surgical excision and radiation therapy. Surgery may also be reserved to excise residual scar tissue and fibrosis after treatment mainly to improve the airway and eliminate the tracheostomy tube. To confirm the definitive diagnosis of solitary plasmacytoma of the larynx, long-term follow-up of many years is necessary in order to rule out multiple myeloma.
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PMID:Plasmacytoma of the larynx. 685 97

Laryngeal amyloidosis (LA) is uncommon and poorly understood, with limited long-term clinicopathologic and immunophenotypic studies in the literature. Eleven cases of LA were retrieved from the files of the Otorhinolaryngic-Head & Neck Tumor Registry from 1953 to 1990. The histology, histochemistry, immunohistochemistry, and follow-up were reviewed. All patients (three women and eight men) presented with hoarseness at an average age of 37.8 years. The lesions, polypoid or granular, measured an average of 1.6 cm and involved the true vocal cords only (n = 4), false vocal cord only (n = 1), or were transglottic (n = 6). An acellular, amorphous, eosinophilic material was present in the stroma, often accentuated around vessels and seromucous glands, which reacted positively with Congo red. A sparse lymphoplasmacytic infiltrate was present in all cases that demonstrated light chain restriction by immunohistochemistry in three cases (kappa = 2, lambda = 1). Serum and urine electrophoreses were negative in all patients. Treatment was limited to surgical excision, including a single laryngectomy. Six patients manifested either recurrent and/or multifocal/systemic disease: two patients with light chain restriction were dead with recurrent disease (mean, 11.1 years); two patients were dead with no evidence of disease (mean, 31.7 years); and two patients were alive, one with light chain restriction and recurrent and multifocal disease (41.6 years) and one with no evidence of disease after a single recurrence (43.4 years). The remaining five patients were either alive or had died with no evidence of disease an average of 32.4 years after diagnosis. No patient developed multiple myeloma or an overt B-cell lymphoma. LA is an uncommon indolent lesion that may be associated with multifocal disease (local or systemic). The presence of an associated monoclonal lymphoplasmacytic infiltrate and recurrent/multifocal disease in the respiratory or gastrointestinal tract of a few cases and the lack of development of a systemic plasma cell dyscrasia or overt systemic B-cell malignancy suggest that some LA may be the result of an immunocyte dyscrasia or tumor of mucosa-associated lymphoid tissue.
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PMID:Amyloidosis of the larynx: a clinicopathologic study of 11 cases. 1082 24

An 84-year-old male with a complaint of hoarseness was examined. A mass lesion was recognized in the false vocal fold. The tumor was excised and found to consist of atypical plasmacytes. Immunopathological examination revealed that leukocyte common antigen (CD45), UCHLI (CD45RO), CD3 and L26 (CD20) were negative and that CD79 and Vs38C were positive. Neither uric Bence-Jones protein nor serum M-protein were observed. No other bony abnormalities were recognized on X-ray examinations including both bone and Ga scintigraphy. No atypical plasmacyte infiltration was observed in bone marrow. Our final diagnosis was extramedullary plasmacytoma of the larynx. Radiotherapy was performed following surgery. The tumor did not progress to multiple myeloma and no recurrence has been observed after 2 years.
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PMID:A case of extramedullary plasmacytoma of the larynx. 1221 82

Multiple myeloma, which primarily affects the elderly, is rare in the head and neck. We report the case of a 71-year-old man who came to us with hoarseness, dysphagia, intermittent aspiration, and cervical lymphadenopathy. Our work-up included laboratory tests, radiographic examinations, analysis of bone marrow aspiration, and histopathologic evaluations. Cervical lymph node biopsy confirmed a diagnosis of multiple myeloma. Despite treatment with chemotherapy and radiation, the patient died of his disease 6 months later.
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PMID:Multiple myeloma in a patient with hoarseness, dysphagia, aspiration, and cervical lymphadenopathy. 1514

Skull base involvement of plasmacytoma is reported in a patient with light chain myeloma. A 39-year-old man was admitted after experiencing paresthesia on the left side of the face and left arm, intermittent diplopia, and hoarseness for 2 years. Cranial magnetic resonance imaging revealed a large midline mass extending from the middle and posterior skull base into the upper two cervical vertebrae. An extramedullary plasmacytoma associated with light chain multiple myeloma was diagnosed after biopsy of the mass and laboratory investigations. The imaging findings and clinical features associated with this rare site of extramedullary plasmacytoma involvement are reported.
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PMID:Skull Base Plasmacytoma in a Patient with Light Chain Myeloma. 1591 74

Bordetella pertussis is a fastidious aerobic, Gram-negative coccobacillus that causes the classical disease of whooping cough. We present a 63 years old man with multiple myeloma who was admitted to the medical department with cough, hoarseness and fever. Bronchopneumonia was suspected and two courses of beta-lactam antibiotics had beneficial effect on his clinical condition, but his respiratory symptoms persisted. Eventually, B. pertussis grew in an aerobic blood culture. Delayed treatment with clarithromycin had little or no effect on his cough. To our knowledge this is the third reported case of B. pertussis bacteraemia. All three patients have been immunocompromized. Growth in blood culture may be slow, and prolonged incubation (at least 6 days) of the blood culture bottles and subculture to a special culture medium is necessary for isolation of B. pertussis.
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PMID:Isolation of Bordetella pertussis in blood culture from a patient with multiple myeloma. 1593 87

A 75-year-old female patient presented with hoarseness and foreign body sensation in the back of her throat of one-month history. Direct laryngoscopy showed bilateral, yellow, hyperemic masses on the left false vocal fold and laryngeal ventricle. Both true vocal folds were mobile. Excisional biopsies of the right false vocal fold and ventricle showed extracellular, insoluble, fibrillar protein accumulation, consistent with amyloidosis. There was no evidence for neoplasm. Serum and urine electrophoreses were negative. The work-up for systemic amyloidosis and multiple myeloma were negative. Treatment was limited to surgical excision. No complications developed within a six-month follow-up period.
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PMID:Amyloidosis of the larynx: a case report. 1748 11


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