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Multiple myeloma

Case contributed by Jan Frank Gerstenmaier
Diagnosis certain

Presentation

"Chesty"

Patient Data

Age: 85 years
Gender: Male
x-ray

No acute cardiopulmonary compromise. Multiple lytic bone lesions in keeping with known multiple myeloma.

Skeletal survey

x-ray

Lateral skull: multiple lytic lesions.

Cervical, thoracic and lumbar spine: multiple lytic lesions.

Chest: multiple lytic lesions in the ribs, scapulae, clavicles, proximal humeri

Pelvis: multiple lytic lesions

Humeri and Femora: multiple lytic lesions

Conclusion:

Appearances are suggestive of multiple myeloma.

MR performed for suspected...

mri

MR performed for suspected cord compression

Heterogeneous marrow signal compatible with the known multiple myeloma. There is a compression fracture involving the inferior cortical endplate of L2. The cord terminates at T12/L1. Cord signal is normal throughout.

No cord or cauda equina compression.

L5/S1 disc bulge contacts the right L5 nerve root.

Case Discussion

Typical features of multiple myeloma with concordant laboratory findings in this case.

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