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 51-year-old woman with large plasmacytoma occurring from the temporal bone is presented. She has a history of multiple myeloma for 9 years. She manifested marked swelling in the left temporal area with tenderness. Neurological examination revealed no abnormality. She showed monoclonal free light chain (lambda type) in the serum and urine, and had multiple osteolytic lesions in her general bones. T1 WI of MRI exhibited a huge mass showing slightly high intensity in the left middle fossa and infratemporal fossa, and a part of the mass protruded into the extracranial space. The mass was markedly enhanced by Gd-DTPA. Angiography showed a hypervascular mass supplied by the external carotid artery. Biopsy disclosed plasmacytoma. She underwent local irradiation of 30 Gy and chemotherapy of Ranimustine (100 mg) and Cyclophosphamide (400 mg). The tumor reduced its size, and tenderness in her temporal area disappeared.
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PMID:[Giant plasmacytoma of the skull which appeared in the clinical course of multiple myeloma--a case report]. 821

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

On plain radiographs, diffuse infiltration of the spine in multiple myeloma may present as diffuse demineralization. Differentiation from osteoporotic changes is then difficult. 15 patients with multiple myeloma and 15 patients with osteoporosis were prospectively examined by MRI using plain and contrast enhanced gradient echo techniques. Examinations were evaluated for lesions and diagnosis was made by two independent observers. Contrast enhancement was visible in lesions detected in myeloma patients and in compression fractures. Fractures could be differentiated from malignant lesions by the fact that there was no multiplicity of enhancing lesions. Contrast enhanced opposed phase gradient echo sequences seem suited for the detection of vertebral involvement in myeloma.
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PMID:[Diffuse demineralization of the lumbar spine. Magnetic resonance tomography studies of osteoporosis and plasmacytoma]. 837 14

Two hundred and fifty-three multiple myeloma patients (136 males and 117 females; mean age 66 years) classified by the clinical criteria of Durie and Salmon underwent skeletal radiography; 148 of them had total body bone scintigraphy, and 130 bone marrow scintigraphy. A selected group of them (18 patients, both males and females) had densitometric bone examination, employing both quantitative computed tomography (QCT) and dual energy X-ray absorptiometry (DXA). The results can be summarized as follows: 29.7% of patients exhibited no skeletal abnormalities at early staging. Spine (49%), skull (35%), pelvis (34%), ribs (33%), humeri (22%), femora (13%), and mandible (10%) were the most frequently involved locations. The main pattern is osteolysis as a characteristic "punched-out" multiple lesion (43.3%), but the most frequent lesion is osteopenia (43.9%), particularly evident in the spine; pathologic fractures (54%) are seen in the ribs, vertebral bodies, limbs; typical radiographic associations of features and sites are observed, which sometimes make diagnosis easier. Total body scintigraphy, revealing aspecific uptake only in the presence of pathologic fractures, is not recommended in the first staging of the disease, but it is considered as an important technique in the follow-up, when the patients become symptomatic. Bone marrow scintigraphy, especially in the "marrow expansion" pattern, might be considered as a form of compensating attempt to recover the lost central space, destroyed by myelomatous involvement, of which it defines the pathologic and prognostic status. Bone densitometry, as it confirms the grade of osteopenia, reveals that osteoporosis is a peculiar characteristic pattern of bone disease in multiple myeloma, not only due to age. Conventional skeletal radiography is the main support in the diagnosis of lytic areas of multiple myeloma, and it remains--today--irreplaceable. The other diagnostic techniques (i.e., CT and MRI) may be used to detect the extent of bone and soft tissue involvement, in areas of complicated anatomy, and to define the degree of marrow involvement.
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PMID:[Bone disease in multiple myeloma. Analysis of 253 controlled cases, with reappraisal of diagnostic criteria and current imaging techniques]. 849 72

Plasma cell tumors (plasmacytomas-PCT) of the bone, or extramedullary PCT, may be diagnosed in patients with or without the diagnostic criteria for systemic multiple myeloma (MM). The reason for the local development of these tumors is not clear. Recent reports emphasize the contribution of CT and MRI in the detection of bone lesions and their expansion into the soft tissues. We report the development of PCT in nine patients with MM under maintenance treatment with alpha-IFN, of whom six had no evidence of systemic relapse and three had indications of early relapse. The PCT were located in the pelvis (4), thoracic (3), cervical (1), and lumbar (2) spine and in 8/9 cases were not demonstrable on plain X-rays. These observations suggest that frequent screening with advanced imaging techniques may detect local disease expansion in asymptomatic patients. Early application of radiochemotherapy may improve prognosis.
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PMID:Development of plasma cell tumors during treatment of multiple myeloma. 864 44

Cranial and intracranial locations have been rarely reported in multiple myeloma. Their occurrence as a harbinger of multiple myeloma seems to have a particular significance. In this report, we discuss a case of multiple myeloma presenting as parasellar syndrome and cranial nerve palsies. A 75-year-old woman was admitted to the hospital in June, 1994, with a 3-month history of headache and a 3-week history of diplopia and photophobia. Physical examination revealed right third, fourth and sixth cranial nerve palsies. MRI scan demonstrated a homogeneous, voluminous mass, isointense in T1-weighted images with the cerebral parenchyma and hyperintense in T2-weighted images, occupying the sphenoid sinus and extending within the sella turcica and right cavernous sinus. Lying above the mass and apparently separated from it by a thin rim of hypointensity was a normal pituitary gland. X rays revealed destructive changes of the sella turcica. A minimal disturbance of endocrine function together with a radiologically abnormal pituitary fossa indicated that the primary lesion might lie outside the pituitary fossa. A diagnosis of IgG-kappa type multiple myeloma was made by pertinent laboratory studies. She received local radiation to the intracranial mass (50 Gy) and conventional chemotherapy. Sixteen months after the therapy she is in good health.
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PMID:[Multiple myeloma presenting as parasellar syndrome and cranial nerve palsies]. 872 53

The authors report a retrospective study of 15 patients with solitary vertebral plasmacytoma. 15 patients were considered in this study on the basis of the following characteristics: 1) histologically confirmed plasmacytoma following surgical removal; 2) existence of a single vertebral lesion, documented by skeletal and MRI scan; 3) no signs, at diagnosis of disseminated disease by blood laboratory test, urine analysis, sternal puncture, iliac bone marrow biopsy, a total-body CT scan. The clinical course of the patients has been analysed on the basis of the following factors: age, sex, length of clinical history before diagnosis, site, presence/absence of the M component. The M component is an electrophoretically homogeneous immunoglobin. The most significant factors for predicting development of multiple myeloma proved to be the presence /absence of the M component at diagnosis and, to a lesser degree, the age of the patient. In the light of other reports too, it would seem that the presence of the M component at diagnosis is a reflection of aggressive biological and clinical tumour behaviour.
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PMID:Solitary plasmacytoma of the spine: relationship of IGM to tumour progression and recurrence. 874

Plasma cell dyscrasias form a heterogeneous group of diseases characterized by the expansion of the number of monoclonal bone marrow plasma cells that produce monoclonal immunoglobulins. Sensitive electrophoretic methods have shown that the incidence of these diseases is as high as 5% in adult individuals. Thus, the majority of cases should be considered to be a normal phenomenon. A few transform into neoplastic diseases, plasma cells becoming responsible for lytic bone lesions, the hallmark of MM. The distinction of benign and malignant forms is frequently difficult at presentation. We can easily recognize solitary myeloma, overt myeloma and plasma cell leukaemia, which require immediate chemotherapy. Therapy could be safely withheld in all the remaining forms, which require only follow-up. Thus, we suggest that plasma cell dyscrasias should be classified simply into two main groups according to the need of immediate chemotherapy. The appearance of new bone lesions and the increase of the M-component level remain the only two criteria that define malignant transformation. Several clinical and laboratory prognostic parameters indicate the risk of transformation, and hence how close the follow-up of the patient should be. Parameters related to the expansion of the plasma cell clone (percentage of bone marrow plasma cells, M-component level, lytic bone lesions and beta 2-microglobulin) are not always very low and very high in the benign and malignant forms, respectively, and frequently overlap in patients with intermediate plasma cell expansions. On the contrary, all parameters related to the intrinsic malignancy of the plasma cells (plasma cell LI, Karyotypic abnormalities and molecular alterations) have, by definition, to be normal in the benign forms. MRI is a new tool that may, early on, reveal lytic bone lesions undetectable by conventional radiography.
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PMID:Plasma cell dyscrasias: classification, clinical and laboratory characteristics, and differential diagnosis. 884 68

Plasmacytomas can be divided into multiple, solitary osseous and solitary extraosseous/extramedullary plasmacytomas. Intracranial plasmacytomas of the dura, leptomeninx and cerebrum are well known from the literature. They are manifestations of multiple myeloma, intracranial extramedullary plasmacytoma or metastatic disease of extramedullary plasmacytoma in distant locations. We describe a cerebellar manifestation of a solitary plasmacytoma of the bone, and a leptomeningeal carcinomatosis of a multiple plasmacytoma. A summary of the literature concerning intracranial plasmacytomas is given. Dural manifestations of plasmacytoma have the same features as meningiomas in CT or MRI. Cerebral or cerebellar manifestations cannot be differentiated from brain tumors by means of CT or MRI. In CT, plasmacytomas show high-density lesions. T2w-MRI reveals a low-intensity lesion. In T1w-MRI, intense homogeneous contrast enhancement can be demonstrated.
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PMID:[Rare intracranial plasmacytoma manifestations. Case reports and review of the literature in diffuse plasmocytoma, in primary solitary extramedullary plasmacytoma in in primary solitary osseous plasmacytoma]. 903 33

Nodular liver infiltration with multiple myeloma is very rare and its findings on MR images have not been, to our knowledge, previously described. The authors report a case of light chain multiple myeloma nodular liver involvement and describe its appearance on US and MRI. Despite their rarity these lesions have distinct MRI features and should be considered in the differential diagnosis of multiple lesions with high SI on T1-weighted images.
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PMID:Nodular liver involvement in light chain multiple myeloma: appearance on US and MRI. 915 11


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