What is the radiographic appearance of multiple myeloma?
The classic radiographic appearance of multiple myeloma is that of multiple, small, well-circumscribed, lytic, punched-out, round lesions within the skull, spine, and pelvis. The pattern of lytic or punched-out radiolucent lesions on the skull have been described as resembling raindrops hitting a surface and splashing.
Does multiple myeloma results in bone lesions?
Multiple myeloma can cause soft spots in the bone called osteolytic lesions, which appear as holes on an X-ray. These osteolytic lesions are painful and can increase the risk of painful breaks or fractures. Myeloma can also cause nerve damage or pain when a tumor presses up against a nerve.
Why bone scan is not useful in multiple myeloma?
In multiple myeloma the osteoblastic response to bone destruction is negligible. The bone scan is often therefore normal or may show areas of decreased uptake (photopaenia). Most studies have shown that the sensitivity of skeletal scintigraphy for detecting individual deposits ranges from 40 to 60% [14, 15].
What bones does multiple myeloma affect?
Myeloma cells grow in the bone marrow and cortical bone, causing local bone damage or generalized thinning of the bone, which is called osteoporosis. This makes the bone more likely to break. The back or ribs are the most common sites of bone pain, but any bone can be affected.
What labs are abnormal with multiple myeloma?
Diagnosing Multiple Myeloma
- High blood calcium level.
- Poor kidney function.
- Low red blood cell counts (anemia)
- Holes in the bones from tumor found on imaging studies (CT, MRI, PET scan)
- Increase in one type of light chain in the blood so that one type is 100 times more common than the other.
What clinical symptoms are caused by multiple myeloma because the malignant cells reside in the bone marrow and not in the circulating blood?
Major symptoms of multiple myeloma may include bone pain, especially in the back and the ribs; low levels of circulating red blood cells (anemia) resulting in weakness, fatigue, and lack of color (pallor); and kidney (renal) abnormalities.
How does myeloma cause bone lesions?
Myeloma cells can form tumors within the bone marrow and spread from the marrow to damage the bone tissue. Myeloma cells can cause bone marrow cells to remove calcium from the bone, which causes soft spots called osteolytic lesions.
Why is myeloma cold on bone scan?
Nuclear medicine The bone scan appearance of patients with disseminated multiple myeloma is variable due to the potential lack of osteoblastic activity. Larger lesions may be either hyperactive (hot) or photopenic (cold). Bone scans may also be normal.
Can you see multiple myeloma on CT scan?
CT is a sensitive imaging modality in detecting the osteolytic effects of multiple myeloma and has a higher sensitivity than plain radiography at detecting small lytic lesions [16].
Why is multiple myeloma so painful?
What causes multiple myeloma pain? Myeloma bone disease causes bone to break down faster than it can be repaired. This can lead to painful conditions like: Osteopenia.
What are the findings of bone scans in multiple myeloma?
A comparative study of radionuclide bone scanning and skeletal radiology in patients with multiple myeloma revealed four principal findings: (i) There were no cases of negative bone scans with positive skeletal radiographs. (ii) Lytic bone lesions were seriously underestimated by bone scans. (iii) B …
What is multiple myeloma (MM)?
Multiple Myeloma (MM) is a cancer of plasma cells resulting from the abnormal proliferation of malignant plasma cells within the bone marrow (BM) microenvironment. MM accounts for 1.3% of all malignancies and 12% of hematologic cancers, and is the second most commonly diagnosed blood cancer after non-Hodgkin lymphoma.
What are the MRI patterns of bone marrow infiltration in multiple myeloma?
There are five MRI patterns of bone marrow infiltration in MM ( Fig E3 ): apparently normal bone marrow, diffuse involvement, focal involvement, combined diffuse and focal involvement, and variegated, or salt and pepper ( 34 ).
Is plain radiograph necessary for multiple myeloma diagnosis?
Plain radiograph. A skeletal survey is essential not only for the diagnosis of multiple myeloma but also in pre-empting potential complications (e.g. pathological fracture) and assessing response to therapy. ~40% bone destruction is required for lesion detection, thus giving the skeletal survey a high false-negative rate of ~50%…