Non-Secretory Multiple Myeloma with Patchy Marrow Involvement and Aberrant Cytokeratin Expression
Non-secretory multiple myeloma is a rare form of the disease that presents a diagnostic challenge. A 69-year-old woman presented to the emergency department with a pathological fracture of the right clavicle, along with a history of asthenia and middle back pain in the preceding three months. Workup...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Ordem dos Médicos
2021-11-01
|
| Series: | Acta Médica Portuguesa |
| Subjects: | |
| Online Access: | https://actamedicaportuguesa.com/revista/index.php/amp/article/view/13235 |
| _version_ | 1817968269516079104 |
|---|---|
| author | Miguel Silva Joana Martins João Pinto Teresina Amaro |
| author_facet | Miguel Silva Joana Martins João Pinto Teresina Amaro |
| author_sort | Miguel Silva |
| collection | DOAJ |
| description | Non-secretory multiple myeloma is a rare form of the disease that presents a diagnostic challenge. A 69-year-old woman presented to the emergency department with a pathological fracture of the right clavicle, along with a history of asthenia and middle back pain in the preceding three months. Workup revealed multiple focal lytic bone lesions in the clavicles, ribs, skull and thoracic- lumbar-sacral spine, without evidence of anemia, hypercalcemia or renal failure, with no abnormal immunofixation in the serum or urine and with normal serum free light chain ratios. The Iliac crest bone marrow aspiration and biopsy revealed a scarcely involved marrow, However, biopsy of one of the focal bone lesions revealed a hypercellular bone marrow with phenotypically abnormal plasmocytes, along with an intriguing, albeit aberrant, cytokeratin expression. Non-secretory multiple myeloma is in itself a rare diagnosis. However, the combination of a patchy marrow involvement and aberrant cytokeratin expression makes this a noteworthy presentation. |
| first_indexed | 2024-04-13T20:06:44Z |
| format | Article |
| id | doaj.art-37d74ab19cbb4928829bf1e30280850d |
| institution | Directory Open Access Journal |
| issn | 0870-399X 1646-0758 |
| language | English |
| last_indexed | 2024-04-13T20:06:44Z |
| publishDate | 2021-11-01 |
| publisher | Ordem dos Médicos |
| record_format | Article |
| series | Acta Médica Portuguesa |
| spelling | doaj.art-37d74ab19cbb4928829bf1e30280850d2022-12-22T02:31:58ZengOrdem dos MédicosActa Médica Portuguesa0870-399X1646-07582021-11-01341110.20344/amp.132355225Non-Secretory Multiple Myeloma with Patchy Marrow Involvement and Aberrant Cytokeratin ExpressionMiguel Silva0Joana Martins1João Pinto2Teresina Amaro3Serviço de Medicina Interna. Hospital Pedro Hispano. Unidade Local de Saúde de Matosinhos. Matosinhos.Serviço de Hematologia. Hospital Pedro Hispano. Unidade Local de Saúde de Matosinhos. Matosinhos.Serviço de Anatomia Patológica. Hospital Pedro Hispano. Unidade Local de Saúde de Matosinhos.Serviço de Anatomia Patológica. Hospital Pedro Hispano. Unidade Local de Saúde de Matosinhos.Non-secretory multiple myeloma is a rare form of the disease that presents a diagnostic challenge. A 69-year-old woman presented to the emergency department with a pathological fracture of the right clavicle, along with a history of asthenia and middle back pain in the preceding three months. Workup revealed multiple focal lytic bone lesions in the clavicles, ribs, skull and thoracic- lumbar-sacral spine, without evidence of anemia, hypercalcemia or renal failure, with no abnormal immunofixation in the serum or urine and with normal serum free light chain ratios. The Iliac crest bone marrow aspiration and biopsy revealed a scarcely involved marrow, However, biopsy of one of the focal bone lesions revealed a hypercellular bone marrow with phenotypically abnormal plasmocytes, along with an intriguing, albeit aberrant, cytokeratin expression. Non-secretory multiple myeloma is in itself a rare diagnosis. However, the combination of a patchy marrow involvement and aberrant cytokeratin expression makes this a noteworthy presentation.https://actamedicaportuguesa.com/revista/index.php/amp/article/view/13235FracturesSpontaneousKeratinsMultiple MyelomaPlasma Cells |
| spellingShingle | Miguel Silva Joana Martins João Pinto Teresina Amaro Non-Secretory Multiple Myeloma with Patchy Marrow Involvement and Aberrant Cytokeratin Expression Acta Médica Portuguesa Fractures Spontaneous Keratins Multiple Myeloma Plasma Cells |
| title | Non-Secretory Multiple Myeloma with Patchy Marrow Involvement and Aberrant Cytokeratin Expression |
| title_full | Non-Secretory Multiple Myeloma with Patchy Marrow Involvement and Aberrant Cytokeratin Expression |
| title_fullStr | Non-Secretory Multiple Myeloma with Patchy Marrow Involvement and Aberrant Cytokeratin Expression |
| title_full_unstemmed | Non-Secretory Multiple Myeloma with Patchy Marrow Involvement and Aberrant Cytokeratin Expression |
| title_short | Non-Secretory Multiple Myeloma with Patchy Marrow Involvement and Aberrant Cytokeratin Expression |
| title_sort | non secretory multiple myeloma with patchy marrow involvement and aberrant cytokeratin expression |
| topic | Fractures Spontaneous Keratins Multiple Myeloma Plasma Cells |
| url | https://actamedicaportuguesa.com/revista/index.php/amp/article/view/13235 |
| work_keys_str_mv | AT miguelsilva nonsecretorymultiplemyelomawithpatchymarrowinvolvementandaberrantcytokeratinexpression AT joanamartins nonsecretorymultiplemyelomawithpatchymarrowinvolvementandaberrantcytokeratinexpression AT joaopinto nonsecretorymultiplemyelomawithpatchymarrowinvolvementandaberrantcytokeratinexpression AT teresinaamaro nonsecretorymultiplemyelomawithpatchymarrowinvolvementandaberrantcytokeratinexpression |