Multiple Myeloma Presenting as Disseminated Osteoblastic Lesions With Intense 18F-FDG Uptake on PET/CT

A 42-year-old woman presented with numbness and weakness in the lower limbs. The radiograph, MRI, and 99mTc-MDP bone scintigraphy revealed multiple bone lesions. The lesions were sclerotic on radiograph. Subsequent 18F-FDG PET/CT showed the lesions were disseminated and had intense 18F-FDG uptake. Monoclonal lambda plasmacytoma was confirmed after CT-guided biopsy of the third lumbar vertebral lesion. The laboratory data also showed a monoclonal immunoglobulin G lambda protein in serum and urine immunofixation. The patient was diagnosed as multiple myeloma finally. Multiple myeloma should be in the differential diagnosis scope of multiple osteoblastic lesions with intense 18F-FDG uptake on PET/CT.