Extraosseous multiple myeloma: imaging spectrum in the abdomen and pelvis
Rachel Cho1, Daniel T Myers2, Ifeoma N Onwubiko3
1Department of Radiology, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI, 48202, USA.
Abstract:
Multiple myeloma represents a subset of plasma cell dyscrasias characterized by the proliferation of plasma cells typically in the bone marrow, representing approximately 1% of all cancers and 15% of hematologic malignancies. Often multiple myeloma is limited to the skeletal system; however, a small percentage (<5%) of patients will develop extraosseous manifestations. We review the current WHO classification of plasma cell dyscrasias and use multimodality imaging including US, CT, MRI, and PET-CT to illustrate the spectrum of extraosseous multiple myeloma in the abdomen and pelvis. Because extraosseous multiple myeloma is associated with a poorer prognosis and decreased survival, it is important for the radiologist to become familiar with a variety of extraosseous manifestations in the abdomen and pelvis, especially in a patient with a known diagnosis of multiple myeloma and the development of an abdominal or pelvic mass.
Insights
Extraosseous multiple myeloma, rare but serious, can manifest in the abdomen and pelvis. Early recognition via imaging is crucial for patient prognosis.
Area of Science:
- Oncology
- Radiology
- Hematology
Background:
- Multiple myeloma is a plasma cell cancer primarily affecting bone marrow.
- Extraosseous manifestations occur in a small percentage of patients.
- These rare presentations are associated with poorer prognosis.
Purpose of the Study:
- To review the WHO classification of plasma cell dyscrasias.
- To illustrate abdominal and pelvic extraosseous multiple myeloma using multimodality imaging.
- To highlight the importance of recognizing these rare manifestations.
Main Methods:
- Review of the current World Health Organization (WHO) classification.
- Multimodality imaging techniques including ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT).
Main Results:
- Extraosseous multiple myeloma can present in various forms within the abdomen and pelvis.
- Imaging findings encompass a spectrum of soft tissue masses and infiltrative patterns.
- Recognition is critical for appropriate patient management.
Conclusions:
- Extraosseous multiple myeloma, though uncommon, requires radiologist awareness.
- Familiarity with imaging findings in the abdomen and pelvis is essential.
- Prompt diagnosis of these manifestations can impact patient survival.
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