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Diagnosing multiple myeloma can be challenging due to rare gastrointestinal involvement. This case highlights the importance of jejunal biopsies for diagnosing plasma cell dyscrasias presenting as chronic diarrhea.

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Area of Science:

  • Gastroenterology
  • Hematology
  • Oncology

Background:

  • Extramedullary involvement of the gastrointestinal tract in plasma cell dyscrasias is uncommon.
  • Plasma cell dyscrasias present with diverse clinical manifestations and diagnostic challenges.

Observation:

  • A 66-year-old man presented with chronic diarrhea, a rare initial symptom of multiple myeloma.
  • Extensive jejunal biopsies were crucial for the presumptive diagnosis.

Findings:

  • The case demonstrates that multiple myeloma can manifest with gastrointestinal symptoms, necessitating thorough investigation.
  • A presumptive diagnosis was made, leading to treatment initiation even without a definitive pathological confirmation initially.

Implications:

  • This case underscores the need for adequate small bowel tissue sampling in patients with unexplained chronic diarrhea.
  • A multidisciplinary approach is essential for the accurate diagnosis and management of plasma cell dyscrasias.
  • Early recognition of unusual presentations can improve patient outcomes in plasma cell dyscrasias.