Immunoglobulin D-lambda type multiple myeloma presenting with FDG-PET/CT negative bone marrow involvement

Intern Med. 2011;50(14):1483-7. doi: 10.2169/internalmedicine.50.5148. Epub 2011 Jul 15.

Abstract

We here report a rare case of a patient with IgD-lambda-positive multiple myeloma presenting with FDG-PET/CT negative bone marrow involvement. A 72-year-old man was admitted to our hospital for evaluation of a paravertebral tumor of the chest. Thoracotomy was performed and a histopathological evaluation of resected intrathoracic tumor demonstrated a plasmacytic neoplasma. Initially we thought that this case was a solitary plasmacytoma because there were no positive findings on postoperative FDG-PET/CT. However, bone marrow aspiration study demonstrated massive infiltration of myeloma cells (72%). It is necessary to recognize that IgD-lambda type myeloma cells may not be sufficiently metabolically active to form high uptake on FDG-PET/CT.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bone Marrow / diagnostic imaging
  • Bone Marrow / pathology
  • Diagnosis, Differential
  • Fluorodeoxyglucose F18
  • Humans
  • Immunoglobulin D / metabolism*
  • Magnetic Resonance Imaging
  • Male
  • Monoclonal Gammopathy of Undetermined Significance / diagnosis
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / diagnostic imaging*
  • Multiple Myeloma / immunology*
  • Plasmacytoma / diagnosis
  • Plasmacytoma / diagnostic imaging
  • Plasmacytoma / immunology
  • Positron-Emission Tomography
  • Radiopharmaceuticals
  • Tomography, X-Ray Computed

Substances

  • Immunoglobulin D
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18