Extraosseous soft tissue uptake-in Multiple Myeloma.

Area of Science:

• Nuclear Medicine
• Oncology
• Radiology

Background:

• Technetium-99m Methylene Diphosphonate (MDP) bone scintigraphy is a standard imaging modality for evaluating bone diseases, including metastatic bone disease.
• Multiple myeloma, a malignancy of plasma cells, often presents with osteolytic lesions that typically exhibit reduced radiotracer uptake on bone scans.
• Despite the typical presentation, bone scintigraphy is frequently performed in multiple myeloma patients due to clinical symptoms mimicking metastatic bone disease.

Observation:

• This report details a unique case of multiple myeloma.
• The patient's bone scan revealed unexpected findings beyond the skeletal system.
• Specifically, non-osseous radiotracer uptake was observed in the lungs and liver.

Findings:

• The bone scan demonstrated significant extraosseous uptake of Tc-99m MDP in the lungs.
• Diffuse hepatic uptake of the radiotracer was also noted in the liver.
• These findings are unusual for multiple myeloma, which typically shows decreased or absent uptake in osteolytic lesions.

Implications:

• This case underscores the importance of considering atypical presentations in multiple myeloma.
• Unusual radiotracer distribution on bone scintigraphy may indicate extramedullary disease or other non-osseous pathology.
• Further investigation is warranted to understand the mechanisms and clinical significance of such extraosseous findings in multiple myeloma.