Abdominal manifestations of multiple myeloma: a retrospective radiologic overview.

BACKGROUND Abdominal manifestations of multiple myeloma (MM) are rare. Herein, the authors study the radiologic characteristics of such involvement because these findings are usually missed by the radiologist and oncologist. PATIENTS AND METHODS We retrospectively reviewed the medical records of 202 patients with MM treated at our institution. A total of 192 patients underwent > or = 1 abdominal imaging studies (ultrasound, computed tomography, magnetic resonance imaging), which were correlated with histopathology, when available. RESULTS Eleven patients (5.72%) had lesions within 13 abdominal sites: liver (n = 4); pancreas (n = 3); peritoneum (n = 2); kidney, stomach, adrenal gland, and retroperitoneum (n = 1), respectively. Cytopathologic diagnosis was available in 5 cases. The remaining cases were considered to have myeloma deposits as a result of previous normal studies and the absence of other primary disease. The imaging findings were nonspecific. CONCLUSION Myeloma deposits within the abdomen are rare. Although the imaging findings are nonspecific, oncologists and radiologists should be aware of their common characteristics.

[1]  A. Jemal,et al.  Cancer Statistics, 2007 , 2007, CA: a cancer journal for clinicians.

[2]  P. Pickhardt,et al.  Primary neoplasms of peritoneal and sub-peritoneal origin: CT findings. , 2005, Radiographics : a review publication of the Radiological Society of North America, Inc.

[3]  J. Monill,et al.  CT features of abdominal plasma cell neoplasms , 2005, European Radiology.

[4]  R. Bouabdallah,et al.  Features of extramedullary and extraosseous multiple myeloma: a report of 19 patients from a single center , 2004, European journal of haematology.

[5]  Stephanie R. Wilson,et al.  Spectrum of imaging findings in abdominal extraosseous myeloma. , 2004, AJR. American journal of roentgenology.

[6]  E. Balliu,et al.  Multifocal involvement of the pancreas in multiple myeloma: sonographic, CT, and MR imaging findings. , 2003, AJR. American journal of roentgenology.

[7]  G. Cathomas,et al.  Simultaneous bilateral spontaneous pneumothorax in a patient with recurrent, extraosseous multiple myeloma , 2003, Postgraduate medical journal.

[8]  Terry M Therneau,et al.  Review of 1027 patients with newly diagnosed multiple myeloma. , 2003, Mayo Clinic proceedings.

[9]  J. Sosna,et al.  Multiple myeloma involving the thyroid cartilage: case report. , 2002, AJNR. American journal of neuroradiology.

[10]  F. Kikuchi,et al.  Immunoglobulin D myeloma presenting as an extraosseous soft tissue tumor , 2001, Skeletal Radiology.

[11]  T. Gemechu,et al.  Solitary plasmacytoma of the mesentery with nodular amyloid deposits: a case report with immunohistochemical evaluation. , 2001, Ethiopian medical journal.

[12]  A. Price,et al.  Hepatic plasmacytomas: case report and review of imaging features. , 1999, Australasian radiology.

[13]  E. Pääkkö,et al.  Plasmacytoma of the pancreas: CT and MRI appearance. , 1998, RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin.

[14]  K. Kaplan,et al.  Multiple myeloma: A patient with unusual features including intracranial and meningeal involvement, testicular involvement, organomegaly, and plasma cell leukemia , 1998, American journal of hematology.

[15]  R. Semelka,et al.  Nodular liver involvement in light chain multiple myeloma: appearance on US and MRI. , 1997, Clinical imaging.

[16]  T. Böhling,et al.  Intracranial plasmacytoma: a case report , 1996, Neuroradiology.

[17]  R. Semelka,et al.  Malignant lesions of the liver with high signal intensity on T1‐Weighted MR images , 1996, Journal of magnetic resonance imaging : JMRI.

[18]  V. Pellegrini,et al.  Multiple myeloma—A rare presentation , 1995 .

[19]  V. Pellegrini,et al.  Case report: multiple myeloma--a rare presentation. , 1995, Clinical radiology.

[20]  M. Dimopoulos,et al.  Extraosseous multiple myeloma: imaging features. , 1993, AJR. American journal of roentgenology.

[21]  M. Dimopoulos,et al.  Extramedullary plasmacytoma of the pancreas. , 1993, American journal of clinical oncology.

[22]  E. Caturelli,et al.  Myelomatous nodular lesions of the liver: Diagnosis by ultrasound‐guided fine‐needle biopsy , 1993, Journal of clinical ultrasound : JCU.

[23]  A. Lupetin,et al.  MR imaging of hepatic plasmacytoma: a case report. , 1992, Clinical imaging.

[24]  M. Suhrland,et al.  Myeloma of the head of the pancreas. A case report , 1991, Cancer.

[25]  Z. Bernstein,et al.  Multiple myeloma presenting as space‐occupying lesions of the Liver , 1990, Cancer.

[26]  I. Francis,et al.  Pancreatic plasmacytoma: CT findings. , 1989, AJR. American journal of roentgenology.

[27]  S. Karp,et al.  Ascites as a Presenting Feature of Multiple Myeloma , 1987, Journal of the Royal Society of Medicine.

[28]  D. Mitchell,et al.  Obstructive jaundice due to multiple myeloma of the pancreatic head: CT evaluation. , 1985, Journal of computer assisted tomography.

[29]  S. Kapadia Multiple myeloma: a clinicopathologic study of 62 consecutively autopsied cases. , 1980, Medicine.

[30]  I. Wickings Putting it together. The patient, the purse, and the practice. , 1977, Lancet.