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Updated: Mar 19, 2026
Interphase Fluorescence in situ Hybridization of Bone Marrow Smears of Multiple Myeloma
Published on: April 15, 2022
Portal hypertension with extensive fibrosis and plasma cell infiltration in multiple myeloma
Raphael Cohen1, Camille Boulagnon2, Florent Ehrhard3
1Reims Teaching Hospitals, Robert-Debré Hospital, Department of Internal Medicine, Infectious Diseases, and Clinical Immunology, 51092 Reims, France.
Abstract:
Plasma cell infiltration of the liver has been described in about 45% of patient with multiple myeloma in autopsy review; however, it is usually not associated with significant liver dysfunction. Indeed, only rare cases of massive plasma cell infiltration leading to non-obstructive cholestasis and hepatic failure have been described. Here, we report a case with a history of 8 years of MM with extensive liver fibrosis and portal hypertension with no other evidence aetiology unless massive plasma cell infiltration who presented a significant regression of both biological liver abnormalities and liver stiffness after ten months of chemotherapy concomitantly to a significant decrease of the IgG serum monoclonal band.
Insights
Liver infiltration by plasma cells is common in multiple myeloma but rarely causes dysfunction. This case shows chemotherapy can reverse liver damage and fibrosis caused by extensive plasma cell infiltration in multiple myeloma.
Area of Science:
- Hepatology
- Oncology
- Hematology
Background:
- Plasma cell infiltration of the liver occurs in approximately 45% of multiple myeloma patients.
- This infiltration typically does not lead to significant liver dysfunction.
- Massive infiltration causing cholestasis and hepatic failure are exceptionally rare.
Observation:
- A patient with an 8-year history of multiple myeloma presented with extensive liver fibrosis and portal hypertension.
- No other etiological factors for liver disease were identified.
- The patient's condition was attributed to massive plasma cell infiltration of the liver.
Findings:
- After ten months of chemotherapy, the patient showed significant regression of biological liver abnormalities.
- Liver stiffness also significantly decreased.
- A concurrent decrease in the IgG serum monoclonal band was observed.
Implications:
- This case highlights that chemotherapy can effectively treat liver damage caused by plasma cell infiltration in multiple myeloma.
- It suggests a potential therapeutic target for managing hepatic complications in multiple myeloma patients.
- Further research may elucidate the mechanisms of liver recovery following treatment.
