Nonsecretory multiple myeloma.
Nonsecretory multiple myeloma (NSMM) is a rare variant of the classic form of multiple myeloma (MM) and accounts for 1% to 5% of all cases of MM. The clinical presentation and radiographic findings of NSMM and MM are the same. The diagnosis of MM requires the detection of a monoclonal gammopathy in the serum or urine. In NSMM, however, no such gammopathy can be demonstrated, making the diagnosis more difficult. We describe a 43-year-old African American woman who initially had back pain and pathologic vertebral compression fractures that were thought to be due to osteoporosis. Five months later, hypercalcemia developed and NSMM was diagnosed. No monoclonal gammopathy was found in the serum or urine, but skeletal survey showed diffuse osteolytic lesions, and bone marrow biopsy revealed marked plasmacytosis. The immunohistochemical techniques and chromosomal analysis methods that are currently available are discussed.
Abdalla
Iman A
IA
Bone Marrow Transplant Program, George Washington University Medical Center, Washington, DC 20037, USA.
Tabbara
Imad A
IA
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001416:Back Pain / Q000209:etiology; D001851:Bone Diseases, Metabolic / Q000209:etiology; D001856:Bone Marrow Examination; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology; D007124:Immunoenzyme Techniques; D009101:Multiple Myeloma / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D010265:Paraproteinemias; D016103:Spinal Fractures / Q000209:etiology