Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지

A Pictorial Review on Extraosseous Manifestations of Multiple Myelomas

다발성골수종의 골외 발현

  • Seo, Jung-Min (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Kyung-Soo (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Yi, Chin-A (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Seong-Hyun (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Byung-Kwan (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Han, Boo-Kyung (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Hyung-Jin (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 서정민 (성균관의대 삼성서울병원 영상의학과) ;
  • 이경수 (성균관의대 삼성서울병원 영상의학과) ;
  • 이진아 (성균관의대 삼성서울병원 영상의학과) ;
  • 김성현 (성균관의대 삼성서울병원 영상의학과) ;
  • 박병관 (성균관의대 삼성서울병원 영상의학과) ;
  • 한부경 (성균관의대 삼성서울병원 영상의학과) ;
  • 김형진 (성균관의대 삼성서울병원 영상의학과)
  • Published : 2011.06.01
⟨ Previous Next ⟩

Abstract

Extraosseous involvement of multiple myelomas can be seen clinically or radiologically in approximately 10-20% of patients at the time of initial diagnosis and may develop in an additional 15% of patients over the course of the disease. The condition can arise in any tissue of the body and its presence has been associated with more aggressive disease, a guarded prognosis, or high-dose chemotherapy. Imaging findings of extraosseous multiple myelomas are diverse. They usually show high enhancement on contrast-medium enhanced CT scans, exhibit iso-signal intensity on both T1- and T2-weighted images, and variable 18F-fluorine deoxyglucose (FDG) uptake at PET. The disease may simulate an infectious condition since it may be concurrent with underlying multiple myelomas per se or it may occur during myeloma treatment including stem cell transplantation.

약 10-20%의 다발성골수종 환자에서 처음 진단 시에 골외 침범이 발견되며 질병의 경과 중 15%의 환자에서 골외 침범이 더 발견된다. 골외 다발성골수종은 신체의 어느 부위에서도 발병할 수 있고 더 침습적이고 예후가 좋지 않은 것으로 알려져 있다. 골외 다발성골수종의 영상의학적 소견은 다양한데, CT에서는 조영 증강이 잘 되고 T1과 T2 강조 영상에서는 동신호강도를 보이며, PET에서는 다양한 정도의 (18F-fluorine deoxyglucose (FDG))흡수를 보인다. 이 질환은 다발성골수종 자체에 의한 혹은 조혈모세포 이식 후에 발생할 수 있는 감염 질환으로 오인될 수 있어 이와의 감별을 요한다.

Keywords

References

  1. Varettoni M, Corso A, Pica G, Mangiacavalli S, Pascutto C, Lazzarino M. Incidence, presenting features and outcome of extramedullary disease in multiple myeloma: a longitudinal study on 1003 consecutive patients. Ann Oncol 2010;21:325-330 https://doi.org/10.1093/annonc/mdp329
  2. Moulopoulos LA, Granfield CA, Dimopoulos MA, Kim EE, Alexanian R, Libshitz HI. Extraosseous multiple myeloma: imaging features. AJR Am J Roentgenol 1993;161:1083-1087 https://doi.org/10.2214/ajr.161.5.8273615
  3. Patlas M, Hadas-Halpern I, Libson E. Imaging findings of extraosseous multiple myeloma. Cancer Imaging 2002;2:120-122
  4. Hall MN, Jagannathan JP, Ramaiya NH, Shinagare AB, Van den Abbeele AD. Imaging of extraosseous myeloma: CT, PET/CT, and MRI features. AJR Am J Roentgenol 2010;195:1057-1065 https://doi.org/10.2214/AJR.10.4384
  5. Damaj G, Mohty M, Vey N, Dincan E, Bouabdallah R, Faucher C, et al. Features of extramedullary and extraosseous multiple myeloma: a report of 19 patients from a single center. Eur J Haematol 2004;73:402-406 https://doi.org/10.1111/j.1600-0609.2004.00331.x
  6. Patriarca F, Zaja F, Silvestri F, Sperotto A, Scalise A, Gigli G, et al. Meningeal and cerebral involvement in multiple myeloma patients. Ann Hematol 2001;80:758-762 https://doi.org/10.1007/s00277-001-0387-6
  7. Masood A, Hudhud KH, Hegazi A, Syed G. Mediastinal plasmacytoma with multiple myeloma presenting as a diagnostic dilemma. Cases J 2008;1:116 https://doi.org/10.1186/1757-1626-1-116
  8. Patlas M, Khalili K, Dill-Macky MJ, Wilson SR. Spectrum of imaging findings in abdominal extraosseous myeloma. AJR Am J Roentgenol 2004;183:929-932 https://doi.org/10.2214/ajr.183.4.1830929
  9. Goh J, Otridge B, Brady H, Breatnach E, Dervan P, MacMathuna P. Aggressive multiple myeloma presenting as mesenteric panniculitis. Am J Gastroenterol 2001;96:238-241 https://doi.org/10.1111/j.1572-0241.2001.03384.x
  10. Oshima K, Kanda Y, Nannya Y, Kaneko M, Hamaki T, Suguro M, et al. Clinical and pathologic findings in 52 consecutively autopsied cases with multiple myeloma. Am J Hematol 2001;67:1-5 https://doi.org/10.1002/ajh.1067