Multiple myeloma

Case contributed by Dr Mohammad Osama Yonso
X-ray

Bony lytic lesions in skull are well defined, as if 'punched out'.

Case Discussion

Multiple myeloma is the most common primary malignant bone neoplasm in adults and results in a wide range of radiographic abnormalities.

Multiple myeloma may simulate carcinomatosis radiologically, but is distinguishable from it by the absence of a known primary lesion and the presence of Bence-Jones proteins in the urine, an abnormal serum electrophoretic pattern with an excess of gamma globulin, and myeloma cells in a marrow biopsy sample.

Four main radiological patterns are recognized 9:

  • type 1: solitary - similar in appearance to bone cysts
  • type 2: multiple osteolytic lesions without marginal sclerosis
    • central
    • peripheral
  • type 3: diffuse osteoporosis with generalized involvement
  • type 4: diffuse osteosclerosis
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Case information

rID: 17706
Published: 6th May 2012
Last edited: 13th Aug 2019
Tag: skull
Inclusion in quiz mode: Included

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