A Case of Multiple Myeloma with Multiple Plasmacytomas pesented as Upper Airway and Esophageal Obstruction.
- Author:
Sang Mi YUN
1
;
Hong Suk SONG
;
Sang Suk LEE
Author Information
1. Department of Internal Medicine, Keimyung University School of Medicine, Korea.
- Publication Type:Case Report
- Keywords:
Multiple myeloma;
Multiple plasmacytoma;
Thyroid;
Lung;
Adrenal gland;
Lymph nodes;
Upper airway obstruction;
Esophageal obstruction;
Vocal cord palsy
- MeSH:
Adrenal Glands;
Aged, 80 and over;
Biopsy;
Bone Marrow;
Deglutition Disorders;
Dexamethasone;
Electrophoresis;
Fatal Outcome;
Female;
Hoarseness;
Humans;
Lung;
Lymph Nodes;
Lymphatic Diseases;
Multiple Myeloma*;
Neck;
Plasma Cells;
Plasmacytoma*;
Pneumonia;
Thyroid Gland;
Tomography, X-Ray Computed;
Ultrasonography;
Vocal Cord Paralysis
- From:Korean Journal of Hematology
1999;34(3):501-506
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Herein, we report a case of multiple myeloma with multiple plasmacytomas of thyroid, lung, lymph nodes and adrenal gland, who presented as upper airway and esophageal obstruction with vocal cord palsy. An 80-year-old women complained of dysphagia, hoarseness and anterior neck mass. Ultrasonography of the neck showed huge inhomogeneous solid mass involving left thyroid lobe and isthmus with several lymphadenopathy along the both upper deep cervical chain. Chest CT scanning revealed 4x3 cm sized, low density mass in posterobasal segment of the right lower lobe with both lower paratracheal lymphadenopathy, and abdominal CT scanning revealed 4.5x4.5 cm sized round low density mass in left adrenal gland. Serum and urine electrophoresis was normal and immunofixation of serum and urine was negative. Bone marrow smear and a bone scintigram revealed no abnormality, but iliac bone marrow biopsy revealed infiltration of abnormal plasma cells. Histologic and immunohistochemical examinations of the thyroid and lung mass revealed monoclonal proliferation of plasma cells of kappa light chain. After local irradiation of the neck with parenteral dexamethasone injection, anterior neck mass was much diminished in size, but 2 weeks later she had a pneumonia with fatal outcome.
