Archive of Old Cases
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- Archive of Old Cases
- 2017
Case No : 1014 Date 2017-04-03
- Courtesy of Yoon Kyung Kim / Gachon University Gil Hospital
- Age/Sex 68 / F
- Chief ComplaintPalpable back mass
Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Multiple myeloma
- Radiologic Findings
- Posteroanterior chest radiograph shows large mass in right posterolateral chest wall, with destruction of right 8th rib. Contrast enhanced chest CT images show soft tissue masses involving the chest wall and the retroperitoneum. PET image shows multifocal hypermetabolic lesions in chest wall, right retroperitoneum and in multiple bones. US-guided needle biopsy of back mass and bone marrow biopsy revealed plasma cell myeloma.
- Brief Review
- Multiple myeloma (MM) is a neoplastic proliferation of plasma cells that is characterized by bone destruction and increased monoclonal immunoglobulin and light chain proteins in the blood and urine. Radiographically, multiple myeloma typically results in multifocal osteolytic lesions in the axial skeleton. A number of MM patients develop soft-tissue extramedullary plasmacytomas (EMPs). In most patients with EMPs, soft tissue tumors arise as direct extensions from skeletal tumors when they disrupt the cortical bone. The remaining tumors result from hematogenous metastatic spread. The hematogenous spread can consist of single or multiple large highly vascularized subcutaneous or skin nodules or nodules in the liver, breast, kidney or CNS involvement, although any organ can be involved.
- References
- 1. Muller NL, Silva CI. Imaging of the chest. Saunders, 2008;1602.
2. Blade J, et al. Soft-tissue plasmacytomas in multiple myeloma: incidence, mechanisms of extramedullary spread and treatment approach. J Clin Oncol 2011;29:3805-3812.
- Keywords
- Multiple myeloma, chest wall, bone,
No. of Applicants : 102
- ▶ Correct Answer : 38/102, 37.3%
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- - Hyogo Prefectural Amagasaki General Medical Center , Japan TOMOAKI OTANI
- - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
- - Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
- - King Abdulaziz University Hospital , Saudi Arabia Amr M. Ajlan
- - McGill University Health Center , Canada Alexandre Semionov
- - Korea University Guro Hospital , Korea (South) Bit Na Park
- - Korea University Guro Hospital , Korea (South) PARK SOYEON
- - Ondokuz Mayis University , Turkey CETIN CELENK
- - the First Affiliated Hospital of NanJing Medical University , China AIPING CHEN
- - Korea University Guro Hospital , Korea (South) GAYOUNG CHOI
- - Korea University Guro Hospital , Korea (South) SOO YOUNG CHAE
- - Seoul National University Hospital , Korea (South) JAE WON CHOI
- - Other , Korea (South) SEONG SU KANG
- - Soonchunhyang University Hospital Seoul , Korea (South) SUNG HWAN BAE
- - The Jikei university , Japan TAKU GOMI
- - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
- - Chungbuk National University Hospital , Korea (South) JUNGHWAN KIM
- - Samsung Medical Center , Korea (South) MIN YEONG KIM
- - , Korea (South) YOUNGKWANG LEE
- - Chungbuk national university , Korea (South) Yong Hun Kim
- - Chonbuk National University Hospital , Korea (South) IM WON HYEONG
- - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey MERIC TUZUN
- - Other , Korea (South) HAYEON LEE
- - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
- - Kyeongpook National University Hospital , Korea (South) SUNGJUN MOON
- - Soonchunhyang University Hospital Seoul , Korea (South) BODA NAM
- - Chonbuk National University Hospital , Korea (South) KUM JU CHAE
- - Chonnam National University Hospital, Radiology department , Korea (South) Park byung jin
- - , Japan MASASHI TAKAHASHI
- - VENKATESHWAR HOSPITAL NEW DELHI , India RAKESH BHATIA
- - Korea university medical center, guro hospital , Korea (South) Lee kyu chong
- - MBAL BURGAS , Bulgaria VLADISLAV BOYANOV RUSINOV
- - Fortis hospital , Mohali , India SHALEEN RANA
- - Bundang CHA hospital , Korea (South) Dongjun Lee
- - Teikyo University Hospital , Japan KAORU SUMIDA
- - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
- - Chungbuk National University Hospital , Korea (South) HYEONMI RYU
- - Korea University Guro Hospital , Korea (South) Yoonmi Choi
- ▶ Correct Answer as Differential Diagnosis : 22/102, 21.6%
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- - Otsu Municipal Hospital , Japan NORIATSU ICHIBA
- - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
- - dayanand , India REENA GUPTA
- - Shiga University of Medical Science , Japan AKITOSHI INOUE
- - Chungbuk National University Hospital , Korea (South) YEONGTAE PARK
- - Kizawa Memorial Hospital , Japan Tomohiro Ando
- - Hostra Northwell School of Medicine , United States ARFA KHAN
- - The University of Tokyo Hospital , Japan Yusuke Watanabe
- - Seoul National University Hospital , Korea (South) SIWON JANG
- - Onomichi municipal hospital , Japan Hirofumi Mifune
- - Ajou University Hospital , Korea (South) Taeyang Ha
- - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
- - Chung buk national university hospital , Korea (South) hong gwon Byun
- - Gifu University Hospital , Japan Yo Kaneko
- - The University of Tokyo Hospital , Japan RYO KUROKAWA
- - Dong-a University Medical Center , Korea (South) WON JIN CHOI
- - Chungbuk National University Hospital , Korea (South) LEE JUNG HWAN
- - Busan National University Hospital , Korea (South) CHANGMU LEE
- - Chungbuk national university hospital , Korea (South) Miran Yeon Yeon
- - Hospital das Clinicas UFG , Brazil PEDRO PAULO TEIXEIRA E SILVA TORRES
- - The University of Tokyo Hospital , Japan TAKU TAJIMA
- - the first affiliatited hospital of nanjing medical univercity , China HAI XU
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