Multiple Myeloma With Mixed Lytic and Blastic Bone Lesions With Lymphadenopathy: Rare Manifestation of a Common Disease-Case Presentation and Literature Review

Abstract

Multiple myeloma - a neoplastic proliferation of plasma cell is the \t\t\tsecond most common blood cancer. Multiple myeloma is characterized \t\t\tby neoplastic proliferation of the plasma cells. These cells \t\t\tinfiltrate variety of organs. Infiltration by immature neoplastic \t\t\tcells and overproduction of monoclonal immunoglobulin chain is \t\t\tresponsible for clinical manifestations of multiple myeloma. The \t\t\tmost common clinical presentation of multiple myeloma is an \t\t\tasymptomatic person having anemia and elevated globulin in \t\t\tlaboratory testing. Multiple myeloma is diagnosed by triad of \t\t\t > 10% marrow infiltration by \t\t\tplasma cells, serum / urine \t\t\tmonoclonal protein and end organ damages. One of the common end \t\t\torgan damage is lytic bone lesions resulting from imbalance between \t\t\tosteolytic and osteoblastic activities. Lymphadenopathy and \t\t\tosteoblastic lesions are rare presentations of multiple myeloma - \t\t\tlymphadenopathy in 1% of cases with IgA subtype and osteoblastic \t\t\tlesions in IgE myeloma and lambda light chains. Osteoblastic \t\t\tmultiple myeloma is a distinct entity from POEMS syndrome. IgG \t\t\tmyeloma with kappa chain predominance is not described yet with \t\t\tosteoblastic lesions and lymphadenopathy. We present a rare case of \t\t\tIgG myeloma with kappa chain predominance that had both \t\t\tlymphadenopathy and osteoblastic lesions. doi:10.4021/wjon440w