Orbital multiple myeloma: case report and review of computed tomography features

Orbital involvement at diagnosis in multiple myeloma is rare. Only a few a cases are reported with computed tomographic features. We report a case of orbital myeloma, and relevant medical reviews on computed tomography features are discussed.     

多发性骨髓瘤累及胸膜一例

患者男,36岁.胸痛,左髋关节后侧抽搐性疼痛.无外伤史,无高热及午后乏力、低热.体检:左髋火节无红肿,病理反射未引出. 胸部CT示双侧锁骨,胸骨限局性低密度影;双侧多个肋骨骨质破坏,周围软组织增厚,双侧胸膜多发不均匀结节样增厚.     

眼眶内神经鞘瘤1例

患者女,23岁。主因左眼稍向外偏斜、视物不清1月余就诊。眼科检查:视力左眼0.4,矫正1.0,左眼球轻度轴性突出,眼球运动无受限,眼底正常;右眼正常。MRI示左侧眼球后方眶尖内见一大小约3.1cm×1.5cm椭圆形稍长T1,     

多发性骨髓瘤1例

患者男,44岁。主因前胸后背疼1个月来就诊,摄左肩关节正位片示:左肩胛骨、左锁骨、左肱骨上段见多发斑片状、穿凿样骨质破坏区,部分边缘清晰,部分融合成片,骨皮质尚光整,(图1)建议CT扫描,CT示颅面骨、多发肋骨、椎     

多发性骨髓瘤1例

患者女性,75岁。因"乏力、纳差、消瘦3个月入院;3个月前无明显诱因纳差,饮食量减少至原来的1/4,曾有黑便,体重减轻20kg。1个月前出现腰骶部酸痛,行走困难。辅助检查:胸部X线片:"右侧第5肋骨改变,考虑骨纤维异     

Multifocal peripheral nerve involvement associated with multiple myeloma

Infiltration of myeloma cells along the peripheral nerve is extremely rare, while multiple myeloma occasionally infiltrates the central nervous system. We present details of a patient in whom multiple myeloma had infiltrated a branch of the femoral nerve of the right inguinal region as well as the left ulnar nerve. The infiltration formed soft tissue masses, with the thickened nerves shown to be penetrating the center of the masses on ultrasonography and magnetic resonance imaging.     

Intracranial involvement in plasmacytomas and multiple myeloma: a pictorial essay

Introduction  The purpose of this pictorial essay is to increase awareness of the clinical presentation, neuroradiological findings, treatment options, and neuroradiological follow-up of plasmacytomas and multiple myeloma with intracranial growth. Methods  This pictorial essay reviews the clinical features and neuroradiological findings in seven patients (four women, three men; age range at diagnosis 62–82 years) followed in two institutions. Six patients, one with IgG-κ plasmacytoma, and five with IgG-κ (n = 3), IgG-λ (n = 1), and nonsecretory (n = 1) multiple myeloma, had been seen over a period of 9 years in one institution, and the other patient with IgG-κ plasmacytoma had been seen over a period of 3.5 years in the other. Results  Intracranial involvement is rare, most frequently resulting from osseous lesions in the cranial vault, skull base, nose, or paranasal sinuses. Primary dural or leptomeningeal involvement is rarer. Some typical findings of a dural and/or osseous plasmacytoma include iso- to hyperdensity on CT scan, T1 equal to high signal intensity and T2 markedly hypointense signal on MRI, and high vascularity possibly documented on intraarterial digital subtraction angiography. However, the neuroradiological findings generally lack specificity, since they are generally no different from those of meningioma, metastasis, lymphoma, dural sarcoma, plasma cell granuloma, infectious meningitis, and leptomeningeal carcinomatosis. Conclusion  The spectrum of clinical and neuroradiological evaluation shows that intracranial involvement from plasmacytoma and multiple myeloma must be taken into account in the differential diagnosis of cranial osseous and meningeal disease. This paper was presented as a Scientific Poster at the 23rd Congress of the Associazione Italiana di Neuroradiologia 2007, the 32nd Congress of the European Society of Neuroradiology 2007, and the Annual Conference of the British Society of Neuroradiologists 2007.     

Gallium-67 demonstration of extensive soft-tissue involvement of multiple myeloma

A 46-year-old woman with multiple myeloma presented with neurological symptoms in the right upper extremity. After MR imaging of the cervical spine failed to show the cause of her symptoms, Ga-67 scintigraphy demonstrated increased uptake in multiple areas including the right supraclavicular region and bilateral lower extremities. Histology of the specimen obtained from the left thigh proved soft-tissue involvement of myeloma, and extensive extramedullary involvement was diagnosed. Radiotherapy to the right supraclavicular mass relieved her symptoms. Although Ga-67 scintigraphy is generally considered of limited value in multiple myeloma, this modality contributed to the development of an appropriate strategy in this patient with extensive extramedullary involvement.     

Multiple myeloma involving the thyroid cartilage: case report

Multiple myeloma involving the thyroid cartilage is exceedingly rare. We describe a patient with progressive airway obstruction due to diffuse involvement of the thyroid cartilage with multiple myeloma. CT revealed a conglomerate of calcifications of the thyroid cartilage. Additional classic lytic lesions of multiple myeloma were subsequently found in the bones, without associated calcifications. Calcified matrix in multiple myeloma involving the thyroid cartilage should now be included as an additional manifestation of extraosseous multiple myeloma.     

CT of uterine cervical myeloma: case report.

Myelomatous involvement of the uterine cervix is rare and, to our knowledge, has not been reported previously in the radiologic literature. This report describes the computed tomographic (CT) findings and reviews differential diagnostic considerations.     

经皮骨水泥成形术治疗胸骨骨髓瘤一例

患者女,68岁。1年前因腰背部剧烈疼痛,行L4椎体活检和经皮椎体成形术,术后病理为骨髓瘤。此次无明显外伤诱因发生胸部正中逐渐疼痛1个月,并向两侧放射,呈持续性,服止痛药无效,影响生活及睡眠。检查:胸骨及两侧肋骨压痛明显,皮肤无红肿,无发热。经X线平片、CT和核素扫描诊断为胸骨骨髓瘤。     

Abnormal radiological features in a multiple myeloma patient: a case report and radiological review of myelomas

Multiple myeloma is the prototype of malignant monoclonal gammopathies. The most common skeletal sites are pelvis, skull, spine, ribs and femoral and humeral shafts. The classic radiographic presentation of multiple myeloma is lytic skeletal lesions. Other types of presentation include sclerotic and porotic changes. Primary sclerotic manifestations are rare and occur in only 3% of cases. Although exceptional, multiple myeloma must be borne in mind in the presence of bone sclerosis. This report presents a patient with multiple myeloma with a sunburst/hair-on-end pattern on the radiograph and sclerotic skeletal lesions.     

Extensive skeletal involvement detected by gallium-67 citrate in a patient with multiple myeloma

Extensive skeletal involvement of multiple myeloma was detected by Ga-67 citrate imaging while searching for infectious foci. The case was unique in that a radiographic skeletal survey showed typical lytic lesions only in the skull, and extensive myeloma involvement in the skeletal system was an incidental finding. A high tumor cell burden was presumed to be present, which led to a rapid and fulminant clinical course in this patient.     

颅骨多发骨瘤1例

患者，男性，28岁。因头部多发肿物入院检查。查体：头颅大小及形态正常，前额及颅顶部可触及多个肿物，质坚硬，不能活动，最大者约3．0cm×2．4cm大小。头颅正侧位X光片示：额骨及左右顶骨见多个大小不等的高密度阴影，密度均匀，边缘清楚，轮廓规则（图1，2），诊断为颅盖骨多发骨瘤。     

Chronic lymphocytic leukemia with breast involvement: case report

This paper presents diffuse breast infiltration in a patient with chronic lymphocytic leukemia. Such presentation is an extremely rare situation. Mammographically a diffuse lesion was evident in the right breast in continuity with enlarged ipsilateral axillary nodes. Local irradiation was effective in resolution of the lesions. Correspondence to: A. Memis