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Perinephric Extramedullary Disease in Multiple Myeloma
Alex Koichi1, Razvan Zemianschi1, Fathima Fijula Palot Manzil2
1From the University of Arkansas for Medical Sciences, Little Rock, AR.
Extramedullary disease in multiple myeloma can rarely affect the kidneys. This study highlights 3 cases of perirenal involvement detected by 18F-FDG PET/CT, emphasizing the need for careful evaluation.
Area of Science:
- Oncology
- Nuclear Medicine
- Radiology
Background:
- Extramedullary disease (EMD) in multiple myeloma signifies aggressive disease and poor prognosis.
- EMD commonly affects soft tissues like skin, muscle, pleura, lymph nodes, liver, and CNS.
- Renal or perirenal EMD is infrequent but can occur in multiple myeloma patients.
Purpose of the Study:
- To report on the presentation and diagnosis of perirenal extramedullary disease in multiple myeloma.
- To evaluate the utility of 18F-FDG PET/CT in identifying renal/perirenal EMD.
- To differentiate perirenal EMD from other renal pathologies.
Main Methods:
- Case series of 3 multiple myeloma patients with suspected perirenal EMD.
- Diagnostic imaging using 18F-FDG PET/CT.
- Histopathological confirmation via tissue sampling for plasma cell infiltration.
Main Results:
- Three cases of perirenal EMD in multiple myeloma were identified.
- 18F-FDG PET/CT detected the extramedullary involvement.
- Tissue sampling confirmed plasma cell infiltration as the cause.
Conclusions:
- Perirenal extramedullary disease is an uncommon manifestation of multiple myeloma.
- 18F-FDG PET/CT is valuable for detecting renal/perirenal EMD, despite renal physiologic uptake.
- Distinguishing perirenal EMD from other renal conditions is crucial for appropriate patient management.
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