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MR of myelomatous meningitis
D J Quint1, R Levy, J C Krauss
1Department of Radiology, University of Michigan Hospitals, Ann Arbor 48109-0030, USA.
AJNR. American Journal of Neuroradiology
|June 1, 1995
Abstract:
In a 56-year-old woman with multiple myeloma involving the leptomeninges diffusely, MR of the spine showed multiple vertebral compression fractures and marked enhancement of the cauda equina region. Intracranial MR showed pathologic enhancement of the left third and fifth cranial nerves.
Insights
Multiple myeloma can spread to the brain and spinal cord, causing nerve damage. This case highlights leptomeningeal multiple myeloma affecting cranial nerves and spinal structures.
Area of Science:
- Neurology
- Oncology
- Radiology
Background:
- Multiple myeloma is a hematologic malignancy.
- Leptomeningeal disease (LMD) occurs when cancer spreads to the meninges.
- LMD in multiple myeloma can present with diverse neurological symptoms.
Observation:
- A 56-year-old woman presented with symptoms suggestive of neurological involvement.
- Magnetic Resonance (MR) imaging of the spine revealed vertebral compression fractures.
- MR imaging also showed diffuse leptomeningeal involvement with enhancement of the cauda equina.
Findings:
- Intracranial MR imaging demonstrated pathological enhancement of the left third and fifth cranial nerves.
- These findings indicate leptomeningeal spread of multiple myeloma.
- The imaging findings correlate with potential neurological deficits related to cranial nerve and spinal cord involvement.
Implications:
- This case underscores the importance of advanced neuroimaging in diagnosing leptomeningeal disease in multiple myeloma.
- Early detection and characterization of LMD are crucial for timely therapeutic intervention.
- Understanding the patterns of leptomeningeal enhancement can guide treatment strategies and prognostication.