multiple myeloma

Multiple Myeloma
-Multiple myeloma must be included in the differential diagnosis of any lytic bone lesion, whether well-defined or ill-defined in age > 40.
-The most common location is in the axial skeleton (spine, skull, pelvis and ribs) and in the diaphysis of long bones (femur and humerus).
-Most common presentation: multiple lytic 'punched out' lesions.
-Multiple myeloma doe not show any uptake on bone scan.
-Discriminator: Must be over age 40.


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multiple myeloma

Multiple Myeloma (2)
Differential diagnosis:
multiple lesions: metastases.
solitary lesion: chondrotumor, GCT and lymphoma.
- On the above a CT-image of a patient with multiple myeloma.Notice the numerous osteolytic lesions and permeative cortical destruction pattern.
In the left sacral wing there is a larger lesion with a high density due to replacement of fatty bone marrow by myeloma (red arrow).


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bone destruction with soft tissue mass

density.

D.D.:

1-multiple myeloma.

2-metastases.

3-osteo-sarcoma.

Reference:BiblioMed Textbook-Computed Body Tomography