Fact-sheet: Multiple myeloma
Updated on 10/06/2016 at 9:12 AM
View all RADEOS cases associated with this fact-sheet
Definition
Malignant monoclonal proliferation of plasma cells
Clinical features
98% of cases after age 40
Pain
Asthenia
Laboratory findings
Normocytic anemia
Renal failure
Hypercalcemia
Proteinuria and Bence Jones proteinuria
Monoclonal gammopathy
Radiography
Tumors predominantly distributed in the axial skeleton: spine > ribs > skull > pelvis > long bones
Early generalized osteopenia
Punched-out osteolytic lesion with endosteal scalloping
Generally spares the posterior elements of the vertebrae
Expansile lesion with soft tissue mass
Possible sclerotic form, sometimes post-treatment sclerosis
CT
Used to assess the degree of bone destruction of a lesion, fracture risk, and when vertebroplasty is being considered.
MRI
T1 hypointense, T2 hyperintense, STIR hyperintense lesions
Excellent for locoregional extraosseous extension and cases of radicular or spinal cord compression
"Salt and pepper" appearance with discrete, punctate signal abnormalities secondary to the presence of multiple small fatty islands within the bone marrow
prognostic value of MRI
