11/113. Lymphoplasmacytic myeloma: an immunological, immunohistochemical and electron microscopic study.An unusual case of a light chain plasma cell myeloma is described. The disease was initially characterized by a diffuse lymphoplasmacytic bone marrow involvement, but subsequently developed widespread extramedullary metastases with anaplastic tumors in the skin which histologically resembled a "histiocytic lymphoma." Electron microscopic examination, in vitro protein synthesis of bone marrow lymphoidal cells, chemical and immunochemical studies of serum and urine proteins, and intracellular immunoglobulin study by the immunoperoxidase technique on the skin biopsy and postmortem tumor tissue demonstrated evidence for lambda light chain synthesis and secretion. These findings provide further support to the notion that the wide spectrum of diverse morphologic patterns seen in lymphoplasmacytic disorders originates from the same progenitor B-lymphoid cell. Distinguishing anaplastic variant of plasma cell myeloma from other undifferentiated neoplasms offers a challenge.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
12/113. Absence of clonal chromosomal relationship between concomitant B-CLL and multiple myeloma--a report on two cases.B-cell chronic lymphocytic leukemia (B-CLL) and multiple myeloma (MM) are chronic B-cell malignancies that represent different stages of B-cell maturation. Occasionally, both diseases are present in the same patient, and this raises the question of clonal associations between the two neoplasms. We here report on two patients with concomitant B-CLL and MM. Clonal chromosomal abnormalities in both lymphocytic cells and plasma cells were studied by interphase fluorescence in situ hybridization (FISH) using a panel of 24 chromosome- and region-specific dna probes. In the first patient, cytogenetics revealed 47, X, t(Y;22)(p11;q10), 12, dell4(q21q32). By FISH, 12 was present in lymphoid cells, but not in plasma cells. MM cells were characterized by multiple chromosomal gains (1, 11q23) and losses (5q, 10, 13q14, 15, 17p13, Y), which were all undetectable in lymphoid cells. The second patient, in whom no clonal abnormalities were obtained by conventional cytogenetic analysis, had lymphoid cells with loss of 8q24 by FISH. In contrast, evidence for a gain of 8q24 (consistent with amplification of c-myc) was obtained in 13% of plasma cells. plasma cells were further characterized by gains of chromosomes 1, 3, 11, 18, and Y. We thus conclude that this comprehensive molecular cytogenetic analysis demonstrates the existence of two clonally distinct B-cell malignancies in both patients.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
13/113. multiple myeloma as the first manifestation of acquired immunodeficiency syndrome: a case report and review of the literature.Various hematologic malignancies and solid tumors are increasingly diagnosed in patients with human immunodeficiency virus (hiv) infection and may be the presenting manifestation of acquired immunodeficiency syndrome (AIDS). multiple myeloma, however, has never been reported as the presenting manifestation of AIDS. We report on a 34-year-old man who presented with back pain, paresthesias, paraparesis, vertebral bony disease, and an associated soft tissue mass. biopsy of the mass revealed immature plasmacytes with very faint cytoplasmic expression of kappa light chains. Bone marrow biopsy revealed 25% infiltration with poorly characterized malignant cells and 15% polyclonal plasma cells. Immunofixation of serum and urine was positive for IgG kappa and kappa light chains, respectively. A bone survey revealed lesions in the skull, left femur bone, and the pelvis. The diagnosis of an anaplastic myeloma was made. Because of the poorly characterized nature of the malignant cells and the difficulties in immunophenotyping, serologic evaluation for hiv was undertaken and was positive. The concept of myeloma as an opportunistic neoplasm defining AIDS was considered. We discuss this view and recommend that patients with multiple myeloma with poorly characterized myeloma cells as well as difficulties in immunophenotyping should undergo testing for hiv infection.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
14/113. Meningeal and cerebral involvement in multiple myeloma patients.Cerebral involvement is an unusual complication in multiple myeloma: herein four patients who presented myelomatous meningitis with multiple intraparenchymal lesions or a localized cerebral plasmacytoma are described. Two of these patients relapsed with meningeal involvement and a very limited disease outside the central nervous system after an initial complete remission obtained with induction chemotherapy. In the other two cases, the cerebral tumor appeared during first-line treatment. Cytological examination of the cerebrospinal fluid and magnetic resonance were essential for diagnosis. Different modalities of treatment were used, including intrathecal chemotherapy, cranial irradiation, and systemic chemotherapy with high-dose methotrexate and cytarabine, achieving improvement of neurological symptoms in three of four patients.- - - - - - - - - - ranking = 0.21229621622435keywords = nervous system (Clic here for more details about this article) |
15/113. An indolent course of multiple myeloma mimicking a solitary thyroid cartilage plasmacytoma.multiple myeloma, solitary plasmacytoma, and extramedullary plasmacytoma constitute a continuum of a disease spectrum, which is called plasma cell neoplasms. These three entities can not be differentiated from each other on a histological basis and, for this reason, clinical evaluation is important in their differential diagnoses. Differential diagnosis guides the proper planning of treatment and helps in estimation of survival. multiple myeloma located within the larynx is very rare. Because of its rarity, any established diagnostic and treatment criteria do not exist. In this report, a case of laryngeal multiple myeloma is presented for its extraordinary presentation and also for educational purposes.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
16/113. Unusual presentation of multiple myeloma with unilateral visual loss and numb chin syndrome in a young adult.A 39-year-old man presented with unilateral visual loss as the first sign of multiple myeloma (MM). His visual loss was due to a plasmacytoma in the sphenoid sinus compressing the optic nerve with resultant optic nerve atrophy. Shortly after this presentation he developed numb chin syndrome due to a mandibular plasmocytoma compressing the mental nerve. His MM progressed rapidly despite treatment with high-dose steroids and alkylating agents and he required allogeneic bone marrow transplantation in order to achieve a remission. We reviewed the published medical literature on the presentation of MM with visual impairment and present a summary in tabular form in this paper. This is the first reported case of MM presenting with isolated complete visual loss due to intracranial extrinsic compression of the optic nerve since the advent of modern cross-sectional imaging. multiple myeloma needs to be included in the differential diagnosis of cranial neuropathies and skull base neoplasms even in adults under 40 years of age.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
17/113. multiple myeloma with myeloma nephropathy in a patient with Hashimoto's thyroiditis.Hashimoto's thyroiditis is associated with myeloproliferative and lymphoproliferative neoplasms. The risk of carcinoma of the thyroid gland is increased in these patients. Furthermore, multiple myeloma can present together with some autoimmune diseases. We report the case of a 57-year-old woman with Hashimoto's thyroiditis who developed multiple myeloma with myeloma nephropathy. Her renal function deteriorated to end stage and she required maintenance hemodialysis. Although autoimmune disorder might play an important role in lymphomagenesis in patients with Hashimoto's thyroiditis, it is not known whether the chronic inflammation that takes place in Hashimoto's thyroiditis stimulates the development of multiple myeloma. The pathogenetic mechanisms responsible for the development of multiple myeloma in patients with Hashimoto's thyroiditis remain unclear.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
18/113. epidermolysis bullosa acquisita and multiple myeloma.The coexistence in the same patient of epidermolysis bullosa acquisita (a rare, autoimmune, acquired mucocutaneous blistering disorder) and multiple myeloma (a plasma cell neoplasm) is extremely uncommon. We describe a patient in whom both of these diseases occurred simultaneously. Intravenous immunoglobulins were used to treat both diseases.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
19/113. Simultaneous bilateral spontaneous pneumothorax in a patient with recurrent, extraosseous multiple myeloma.A patient with simultaneous bilateral spontaneous pneumothorax (SBSP) due to pulmonary and pleural manifestations of recurrent multiple myeloma is presented. The patient died in shock of unknown cause. The diagnosis was suspected from pleural fluid examination showing an exudate with numerous plasmocytes. Macroscopically and histologically, the visceral organs and the bone marrow were infiltrated with multiple monoclonal proliferations of plasma cells staining positively for IgG and lambda chains. SBSP is a rare condition and may be caused by trauma, parenchymal lung disease, infections, or neoplasms. This is the first report of SBSP caused by pleuropulmonary infiltration of multiple myeloma.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
20/113. Intra-cerebral relapse following prolonged remission after autologous stem cell transplantation for multiple myeloma.central nervous system (CNS) myeloma is a rare phenomenon, especially so after high-dose therapy (HDT) and stem cell transplantation. We describe a case of isolated CNS relapse of myeloma post autologous transplantation that followed a prolonged progression-free interval. Issues regarding the pathophysiology and management of this unusual complication are discussed.- - - - - - - - - - ranking = 0.21229621622435keywords = nervous system (Clic here for more details about this article) |
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