title: Multiple myeloma presenting clinically as lymphoma.
abstract: Multiple myeloma typically presents with monoclonal proteinemia, marrow plasmacytosis, anemia, bony involvement, hypercalcemia and renal insufficiency. Less frequent presentations include hepatic and splenic enlargement (5% of cases), lymphadenopathy (4%) and biclonal gammopathy (1%). Chemotherapy may produce remissions in 50% of cases, but relapses are the rule and mean survival is approximately 2.5 years. To improve survival, marrow transplantation is being explored as a therapeutic modality in younger patients. In this report we describe a unique case of multiple myeloma presenting clinically as lymphoma. The patient presented with fever, widespread lymphadenopathy and pleuropulmonary involvement and responded promptly to multiagent doxorubicin-based chemotherapy. This was followed by high-dose chemotherapy and allogeneic bone marrow transplantation and the patient remains in remission more than 36 months post transplant. This case report suggests that myeloma simulating lymphoma may be a chemosensitive and potentially curable myeloma variant.
authors.affiliation: Section of Hematology and Oncology, Manitoba Cancer Treatment and Research Foundation, Winnipeg, Canada.
authors.forename: P J
authors.initials: PJ
authors.lastname: Daeninck
authors.forename: G J
authors.initials: GJ
authors.lastname: Williams
authors.forename: M
authors.initials: M
authors.lastname: Rubinger
authors.forename: J B
authors.initials: JB
authors.lastname: Johnston
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000628:therapy