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)

A retrospective comparison was made between 99mTc-MDP bone scans and corresponding spine MR images in 35 patients who had complementary studies within 2 mo. Bone scans were performed with planar imaging of the entire body and MRI was performed with a 1.5 tesla signal scanner using standard techniques with T1- and T2-weighted images. There were 18 male and 17 female patients diagnosed with cancer prior to these studies. Cancer diagnoses included 14 prostate, 12 breast, 1 bladder, 2 renal, 2 lung, 1 each of esophagus, melanoma, myeloma and adenocarcinoma of unknown primary cancer. Of the regions compared, 69 were positive for bony metastases by MRI and 63 regions by bone scans. Thirty-eight regions were concordantly positive and 56 regions concordantly negative. No patients with entirely positive bone scans were negative by MRI, but one patient was entirely positive by MRI but negative by a bone scan. At least one region was discordantly read in 21 patients. Distribution of positive regions was similar on bone scan and MRI. The greatest number and proportion of discordant readings occurred in the lumbar regions and more frequently in patients with prostate cancer. Considering its widespread availability and the ease of performing a whole-body survey for metastasis, radionuclide bone scanning remains the study of choice for initial evaluation of patients with cancer. However, MRI is an excellent complementary technique when bone scan findings are inadequate for answering clinical questions. MRI appears to be quite sensitive and probably more specific for metastasis in certain locations of the spine.
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PMID:Comparison of radionuclide bone scans and magnetic resonance imaging in detecting spinal metastases. 825 11

A monoclonal antibody (mAb), named TE-4F 10, was produced by fusing P3X-Ag8 myeloma cells with splenocytes of BALB/c mice immunized with a rat medullary thymic epithelial cell (TEC) line, (TE-R 2.5), previously established in our Institute. Flow cytometry showed that 85-95% TE-R 2.5 cells expressed the TE-4F10 antigen. The mAb immunoprecipitated a 29 kDa molecule from the TE-R2.5 cell lysate. Immunohistochemical analysis using single and double staining of the thymus with anti-cytokeratin (CK) mAb, showed that TE- 4F10 mAb selectively stains a subpopulation of medullary TEC. Hematopoietic and lymphoid cells were negative. The expression of the TE-4F10 antigen on TE-R 2.5 cells in vitro was significantly upregulated by interleukin 1 (IL-1) and tumor necrosis factor (TNFalpha). Other cytokines IL-4, IL-6, IL-10 and granulocyte - macrophage colony stimulating factor (GM-CSF) showed lesser stimulation on its expression, whereas interferon gamma (IFN) and dexamethasone were without significant effect. The TE-R 2.5 cell line strongly bound and induced apoptosis of a rat / mouse thymocyte heterohybridoma (BWRT8), phenotypically alphabetaTCRhiCD4hiCD8lo. TE-4F10 mAb significantly inhibited binding (40-50%) of both BWRT8 cells and the BWRT8 - MDP.1 subclone to TE-R 2.5 cells. The inhibition was enhanced when TEC were stimulated with IL-1 + TNFalpha. The mAb also significantly blocked apoptosis of BWRT8 but did not modulate cell death of the BWRT8 - MDP.1 subclone, which was resistant to TEC-induced apoptosis. These findings indicate that the TE-4F10 antigen might be selectively involved in adhesion and selection processes in the medullary thymic microenvironment. The mAb of the same characteristics has not been described so far.
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PMID:Biochemical and functional characterization of a molecule expressed by a subset of thymic medullary epithelial cells. 1129 58

Six hundred years before Christ, Hippocrates said that physicians on exercising their medical duties, should benefit but not harm their patients. Seventy years ago increased medical radiation caused radiologists in the US an excess risk of leukemia, lymphoma and multiple myeloma. Now medical radiation is rather safe for the physician but the question remains if proper prophylactic measures are being taken to make it safe for the subjects examined. Roughly, first trimester of pregnancy radiography has a much greater fatal cancer risk than that of exposures taken later in pregnancy. It is suggested that women should be administered the minimum activity consistent with achieving the desired clinical information, whether or not they are known to be pregnant. The best available risk estimates suggest that pediatric CT diagnostic procedures will induce significantly increased lifetime radiation risk in children. Professor Roger Clarke wrote that there may be a need to reduce or prevent doses of medical radiation up to 3 mSv if there is no benefit to the individual. 30 mSv is described as "a dose which should not be exceeded" and can be approached only if there is a benefit to individuals and the dose is difficult to reduce or prevent. In WHO Category III a) Static brain imaging with technetium-99m pertechnetate, b) Gated cardiac imaging c) Bone imaging with technetium-99m MDP, c) Quantitative haemodynamics with technetium-99m pertechnetate, d) myocardial imaging with thallous-201 chloride and e) abscess imaging with gallium-67 citrate, induce an effective dose equivalent of 5-9 mSv. A CT scan commonly gives 25 mSv to the subject examined. BEIR VI indicated that a 10 mSv single population dose is associated with a lifetime attributable risk for developing a solid cancer or leukemia in 1:1000. Multiple CT examinations have administered to some patients with renal colic a dose of 19.5-153.7 mSv. One may suggest that there should be "justification" and informed written patients' consent for nuclear medicine examinations administering to the patient doses greater than 5 mSv, especially doses around or above 30 mSv / year.
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PMID:The physician should benefit, not harm the patient. 1689 9

Radiation therapy can be an effective means to treat bone metastases, which occur in more than 50% of cancer patients. (153)Samarium lexidronam ((153)Sm-EDTMP; Quadramet, Cytogen) is a radiopharmaceutical designed for deposition into bone metastases. Bone scans can identify patients that may benefit from targeted radiation therapy with (153)Sm-EDTMP. As an unsealed source of radiation therapy, (153)Sm-EDTMP is simple to administer: 1 mCi/kg is given in a similar fashion to a bone scan injection ((99m)Tc-MDP bone scan injection is given at 0.2-0.35 mCi/kg. Therefore, both are administered intravenously. However, the radiation-absorbed dose and radiopharmaceutical energy are different). Nevertheless, despite simplicity of administration, (153)Sm-EDTMP is underutilized for improving cancer pain in the skeleton. Repeated cycles and combined treatment with other modalities such as bisphosphonates, chemotherapy and/or external beam radiation are possible. (153)Sm-EDTMP combined with bisphosphonates, chemotherapy and/or radiation may provide better palliation of bone metastases and also in bone-forming tumors (osteosarcoma). Encouraging experience using high-dose (153)Sm-EDTMP for total marrow irradiation in hematologic malignancies involving the bones (e.g., myeloma or acute leukemia) is also reviewed.
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PMID:Samarium lexidronam (153Sm-EDTMP): skeletal radiation for osteoblastic bone metastases and osteosarcoma. 1802 Sep 21

Nitrogen-containing biphosphonates are a group of medications that are increasingly used in the management of Paget's disease, fibrous dysplasia, osteoporosis, multiple myeloma and metastatic prostate or breast cancer bone disease. On 2004 it was established that nitrogen-containing biphosphonates may induce jaw osteonecrosis and since then, a substantial number of publications has supported this finding. Jaw osteonecrosis may be asymptomatic, lasting for about a year or symptomatic, accompanied with mild or severe pain. Jaw osteonecrosis usually results in patients with poor dental hygiene, or subjected to invasive dental procedures. Its incidence increases with the length of nitrogen-containing biphosphonates treatment and appears to be higher for the Zometa(TM) users. It is important to early recognize this entity, since early intervention can make a significant difference to the outcome of this debilitating side effect. We here report three patients who had a positive technetium-99m methylene diphosphonate ((99m)Tc-MDP) bone scan. One of these patients also had osteomyelitis and was treated aggressively. The other two were treated in a more conservative manner. Detailed dental examination supported the scintigraphic findings. Biopsy was performed only in one patient and also offered specimens for antibiotic cultures. In discussion, jaw biopsy is a debatable procedure in the setting of jaw osteonecrosis and many consider that it should be avoided in most cases, except if it is necessary to establish the diagnosis and suggest antibiotic treatment by obtaining samples for bacterial cultures. Although axial tomography and magnetic resonance imaging are useful in defining the extent of the disease, 3-phase (99m)Tc-MDP bone scan is the most sensitive imaging modality pinpointing the disease at its early stages. In conclusion, a 3-phase (99m)Tc-MDP scan with anterior and lateral views of the skull is indicated in all symptomatic or asymptomatic patients, with a history of long-term nitrogen-containing biphosphonate treatment, since this may lead to an early detection of the disease.
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PMID:Jaw uptake of technetium-99 methylene diphosphonate in patients on biphosphonates: a word of caution. 1808 61

Bone plasmacytoma is a rare plasma cell neoplasm that can present with a polyradiculoneuropathy. A 57-year-old man presented with 2-month history of progressive weakness and numbness of both legs. Neurological examination showed symmetric distal weakness, reduced vibration senses in limbs and areflexia. CSF had high protein content. Electrophysiological evaluation revealed a demyelinating sensory-motor polyneuropathy. IgG-lambda paraprotein was present in serum. Full skeletal survey, spinal MRI and body CT-scan were normal. 99mTc-methylene-dyphosphonate scintigraphy (99mTc-MDP) revealed a solitary accumulation in the sternum. Biopsy of the lesion demonstrated a plasmacytoma. We emphasize that 99mTc-MDP scintigraphy can be a useful screening procedure for patients with polyradiculoneuropathy and occult bone plasmacytoma.
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PMID:Sensory-motor polyradiculoneuropathy as the first manifestation of sternum bone plasmacytoma only revealed by bone scintigraphy. 1907 Apr 87

Multiple benign osteolytic lesions are very hard to differentiate from disseminated bone metastasis. Whole-body bone scintigraphy (WBBS) with technetium-99m methylene diphosphonate (Tc-99m MDP) demonstrates multiple lesions with increased uptake in any bone involved. Even combined with medical history and multiple imaging results, such as MRI and CT, the clinical diagnosis of metastasis lesion remains as a challenge. These clinical characteristics are similar to multiple malignant bone metastases and therefore affect the following treatment procedures. In this paper, we analyzed multiple benign osteolytic lesions, like eosinophilic granuloma (EG), multiple myeloma (MM), disseminated tuberculosis, fibrous dysplasia, or enchondroma, occurring in our daily clinical work and concluded that additional attention should be paid before giving the diagnosis of multiple bone metastases.
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PMID:Multiple metastasis-like bone lesions in scintigraphic imaging. 2250 21

Amyloidosis is a rare disorder characterized by variable extracellular accumulation of a complex substance consisting of proteinaceous fibrils (amyloid fibrils) and nonfibrillar glycoprotein or amyloid P component. We present a case of a primary systemic amyloidosis associated with multiple myeloma in a 48-year-old woman whose Tc-MDP SPECT/CT study revealed extraosseous periarticular uptake in amyloid deposits with no abnormal focal tracer uptake in the bone.
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PMID:99mTc-MDP SPECT/CT demonstrating extraosseous periarticular amyloid deposits in primary systemic amyloidosis associated with multiple myeloma. 2527 14

A 59-year-old man presented with a 7-month history of increasing left shoulder pain. The initial plain films showed near absence of the left scapula and scattered lucent changes in the left humerus. A CT scan confirmed the presence of widespread lytic bony lesions, with a large soft-tissue mass centered around the left scapula. An isotope bone scan demonstrated marked uptake of MDP in the stomach and nasal mucosa. Further laboratory investigations revealed marked hypercalcemia and the presence of Bence-Jones protein in the urine. An ultrasound-guided biopsy of the soft-tissue mass confirmed the diagnosis of multiple myeloma.
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PMID:Marked gastric uptake of Tc-99m methylene diphosphonate (MDP) in a patient with myeloma and hypercalcemia. 2733 May 91

A 69-year-old man with a history of low back pain for more than 4 months underwent Tc-MDP bone scan to determine the cause of the symptoms. In addition to the osseous lesions, significant activity in the stomach wall was noted. However, a subsequent F-NaF PET/CT only revealed bone lesion without increased activity in the stomach wall. The cause of the back pain was eventually confirmed due to multiple myeloma.
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PMID:Significant 99mTc-MDP but Unimpressive 18F-NaF Gastric Activity in a Patient With Multiple Myeloma. 2750 9


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