Presentation
Generalized malaise, neck and shoulder pain. Found to be hypercalcemic.
Patient Data
Throughout the imaged skeleton there are extensive lytic lesions with associated soft tissue components.
There are lesions in the scapulae, throughout the thoracic and lumbar spine, manubrium, multiple ribs bilaterally, throughout the bony pelvis and also in the left femoral neck.
Pathological fractures of the T1 left lamina and L3 vertebral body.
Patient underwent biopsy that revealed:
MICROSCOPIC DESCRIPTION: The sections show fragments of mature lamella bone admixed with mature adipose and some devitalised bone fragments. Scattered throughout the specimen are variably sized sheets of plasmacytoid cells with uniform round to slightly oval nuclei with hypochromatic vaguely clock face chromatin, eccentrically placed nucleus and a small amount of eosinophilic cytoplasm. Mitoses are noted. Normal hematopoietic tissue is also seen. The appearances are in keeping with plasma cell myeloma.
DIAGNOSIS: Left femur reamings: Features consistent with plasma cell myeloma (multiple myeloma).