title: Immunoglobulin D-lambda type multiple myeloma presenting with FDG-PET/CT negative bone marrow involvement.
abstract: We here report a rare case of a patient with IgD-lambda-positive multiple myeloma presenting with FDG-PET/CT negative bone marrow involvement. A 72-year-old man was admitted to our hospital for evaluation of a paravertebral tumor of the chest. Thoracotomy was performed and a histopathological evaluation of resected intrathoracic tumor demonstrated a plasmacytic neoplasma. Initially we thought that this case was a solitary plasmacytoma because there were no positive findings on postoperative FDG-PET/CT. However, bone marrow aspiration study demonstrated massive infiltration of myeloma cells (72%). It is necessary to recognize that IgD-lambda type myeloma cells may not be sufficiently metabolically active to form high uptake on FDG-PET/CT.
authors.affiliation: Division of Pulmonary Medicine, National Hospital Organization National Kochi Hospital, Japan. machidah@kochi2.hosp.go.jp
authors.forename: Hisanori
authors.initials: H
authors.lastname: Machida
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Shinohara
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hino
authors.forename: Mitsuteru
authors.initials: M
authors.lastname: Yoshida
authors.forename: Nobuo
authors.initials: N
authors.lastname: Hatakeyama
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Okano
authors.forename: Mami
authors.initials: M
authors.lastname: Inayama
authors.forename: Emiko
authors.initials: E
authors.lastname: Hosokawa
authors.forename: Shuichi
authors.initials: S
authors.lastname: Abe
authors.forename: Keishi
authors.initials: K
authors.lastname: Naruse
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Iwahara
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Ogushi
mesh_terms: D000368:Aged; D001853:Bone Marrow / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007072:Immunoglobulin D / Q000378:metabolism*; D008279:Magnetic Resonance Imaging; D008297:Male; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000175:diagnosis; D009101:Multiple Myeloma / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000276:immunology*; D010954:Plasmacytoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000276:immunology; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D007072:Immunoglobulin D; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18