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Updated: Jul 18, 2026
Repression of Multiple Myeloma Cell Growth In Vivo by Single-wall Carbon Nanotube (SWCNT)-delivered MALAT1 Antisense Oligos
Published on: December 13, 2018
[A neuron specific enolase-producing multiple myeloma]
Junko Jimbo1, Kazuya Sato, Katsuya Ikuta
1Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical College.
Insights
This study reports a rare case of IgG-lambda multiple myeloma presenting as a chest-wall plasmacytoma. The myeloma cells produced neuron-specific enolase (NSE), which normalized after treatment.
Area of Science:
- Oncology
- Hematology
- Biochemistry
Background:
- Multiple myeloma is a plasma cell malignancy.
- Extramedullary plasmacytomas can occur in various locations.
- Neuron-specific enolase (NSE) is a biomarker typically associated with neuroendocrine tumors.
Observation:
- A 53-year-old woman presented with chest-wall pain, a chest-wall mass, pleural effusion, anemia, hypercalcemia, and elevated IgG levels.
- Diagnostic workup revealed IgG-lambda monoclonal protein and elevated NSE.
- Biopsy confirmed atypical plasma cell proliferation consistent with multiple myeloma and chest-wall plasmacytoma.
Findings:
- Atypical plasma cells stained positive for cytoplasmic CD38 and IgG-lambda.
- Immunostaining demonstrated diffuse NSE expression within the myeloma cells, suggesting NSE production by these malignant cells.
- Treatment with chemotherapy and radiotherapy led to tumor regression and normalization of IgG and NSE levels.
Implications:
- This case adds to the limited literature on NSE-producing multiple myeloma.
- Elevated NSE may serve as a potential biomarker for myeloma activity in specific cases.
- The findings highlight the diverse clinical presentations of multiple myeloma and the potential for unusual biomarker expression.
Abstract:
A 53-year-old woman was admitted to our hospital with left chest-wall pain. Computed tomography scans showed a homogenous mass on the left chest-wall with pleural effusion. Laboratory data showed anemia, hypercalcemia, and high levels of serum IgG. An IgG-lambda monoclonal protein was detected with serum immunoelectrophoresis. In addition, the serum level of neuron specific enolase (NSE) was elevated. A chest-wall tumor biopsy and a bone marrow aspiration revealed diffuse proliferation of atypical plasma cells, which were positive for cytoplasmic CD38 and IgG-lambda. The patient was diagnosed as having IgG-lambda type multiple myeloma with a chest-wall plasmacytoma. Immunostaining revealed diffuse NSE staining in the cytoplasm of the atypical plasma cells. These findings suggested that the myeloma cells produced NSE. The left chest-wall tumor and bone marrow myeloma cells disappeared following several courses of chemotherapy and radiotherapy and the serum levels of IgG and NSE also normalized. No recurrence of the multiple myeloma was seen after an autologous peripheral blood stem cell transplantation. This is the second report of an NSE-producing multiple myeloma. Interestingly, our case has similar clinical phenotypes with the previously reported case, such as chest-wall plasmacytoma, pleural effusion and hypercalcemia.
