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Nonsecretory multiple myeloma.

D R Doster1, J Folds, D A Gabriel

  • 1Lineberger Cancer Research Center, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill 27514.

Archives of Pathology & Laboratory Medicine
|February 1, 1988
PubMed
Summary
This summary is machine-generated.

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Nonsecretory multiple myeloma, a rare form of the cancer, was diagnosed in two patients presenting with severe back pain and bone lesions. Despite lacking detectable paraproteins, bone marrow analysis confirmed plasma cell proliferation.

Area of Science:

  • Hematology
  • Oncology
  • Immunology

Background:

  • Multiple myeloma is a plasma cell malignancy often characterized by the presence of a monoclonal paraprotein in serum or urine.
  • Nonsecretory multiple myeloma (NSMM) is a subtype where paraproteins are undetectable, posing diagnostic challenges.

Observation:

  • Two patients presented with severe back pain and radiographic evidence of multiple bony lytic lesions.
  • Bone marrow examinations revealed sheets of plasma cells, consistent with myeloma.
  • Standard serum and urine tests failed to detect any paraproteins.

Findings:

  • Immunofluorescent staining of bone marrow plasma cells confirmed the presence of intracytoplasmic J chains.
  • This finding supports the diagnosis of NSMM, indicating intracellular immunoglobulin production without secretion.

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Implications:

  • Highlights the importance of bone marrow examination and immunofluorescence in diagnosing nonsecretory multiple myeloma.
  • Suggests that intracytoplasmic J chain presence is a key indicator for this rare myeloma variant.
  • Underscores the need for comprehensive diagnostic approaches beyond paraprotein detection in suspected multiple myeloma cases.