Non-Secretory Multiple Myeloma with Patchy Marrow Involvement and Aberrant Cytokeratin Expression

Detalhes bibliográficos
Autor(a) principal: Silva, Miguel
Data de Publicação: 2021
Outros Autores: Martins, Joana, Pinto, João, Amaro, Teresina
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13235
Resumo: Non-secretory multiple myeloma is a rare form of the disease that presents a diagnostic challenge. A 69-year-old woman presented to the emergency department with a pathological fracture of the right clavicle, along with a history of asthenia and middle back pain in the preceding three months. Workup revealed multiple focal lytic bone lesions in the clavicles, ribs, skull and thoracic- lumbar-sacral spine, without evidence of anemia, hypercalcemia or renal failure, with no abnormal immunofixation in the serum or urine and with normal serum free light chain ratios. The Iliac crest bone marrow aspiration and biopsy revealed a scarcely involved marrow, However, biopsy of one of the focal bone lesions revealed a hypercellular bone marrow with phenotypically abnormal plasmocytes, along with an intriguing, albeit aberrant, cytokeratin expression. Non-secretory multiple myeloma is in itself a rare diagnosis. However, the combination of a patchy marrow involvement and aberrant cytokeratin expression makes this a noteworthy presentation.
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spelling Non-Secretory Multiple Myeloma with Patchy Marrow Involvement and Aberrant Cytokeratin ExpressionMieloma Múltiplo Não-Secretor Com Envolvimento “Patchy” da Medula Óssea e Expressão Aberrante de CitoqueratinasFracturesSpontaneousKeratinsMultiple MyelomaPlasma CellsFraturas EspontâneasMieloma MúltiploPlasmócitosQueratinasNon-secretory multiple myeloma is a rare form of the disease that presents a diagnostic challenge. A 69-year-old woman presented to the emergency department with a pathological fracture of the right clavicle, along with a history of asthenia and middle back pain in the preceding three months. Workup revealed multiple focal lytic bone lesions in the clavicles, ribs, skull and thoracic- lumbar-sacral spine, without evidence of anemia, hypercalcemia or renal failure, with no abnormal immunofixation in the serum or urine and with normal serum free light chain ratios. The Iliac crest bone marrow aspiration and biopsy revealed a scarcely involved marrow, However, biopsy of one of the focal bone lesions revealed a hypercellular bone marrow with phenotypically abnormal plasmocytes, along with an intriguing, albeit aberrant, cytokeratin expression. Non-secretory multiple myeloma is in itself a rare diagnosis. However, the combination of a patchy marrow involvement and aberrant cytokeratin expression makes this a noteworthy presentation.O mieloma múltiplo não-secretor é uma forma rara da doença e um desafio diagnóstico. Uma mulher de 69 anos recorreu ao serviço de urgência com uma fratura patológica da clavícula direita e uma história de astenia e dorsalgia com três meses de evolução. A investigação revelou múltiplas lesões ósseas focais osteolíticas nas clavículas, costelas, crânio e coluna dorso-lombo-sagrada, sem evidência de anemia, hipercalcemia ou insuficiência renal, sem imunofixação anormal no soro ou na urina e com rácios de cadeias leves livres normais. O aspirado e biópsia de medula óssea da crista ilíaca revelou um escasso envolvimento por plasmócitos. No entanto, a biópsia de uma das lesões focais revelou uma medula hipercelular com plasmócitos fenotipicamente anormais e com uma aberrante expressão de citoqueratinas. O mieloma múltiplo não-secretor é por si só um diagnóstico raro. Contudo, a combinação de envolvimento irregular da medula e a expressão aberrante de citoqueratinas são merecedoras de atenção.Ordem dos Médicos2021-11-02info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13235oai:ojs.www.actamedicaportuguesa.com:article/13235Acta Médica Portuguesa; Vol. 34 No. 11 (2021): November; 778-781Acta Médica Portuguesa; Vol. 34 N.º 11 (2021): Novembro; 778-7811646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13235https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13235/6435Direitos de Autor (c) 2021 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessSilva, MiguelMartins, JoanaPinto, JoãoAmaro, Teresina2022-12-20T11:06:49Zoai:ojs.www.actamedicaportuguesa.com:article/13235Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:19.792066Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Non-Secretory Multiple Myeloma with Patchy Marrow Involvement and Aberrant Cytokeratin Expression
Mieloma Múltiplo Não-Secretor Com Envolvimento “Patchy” da Medula Óssea e Expressão Aberrante de Citoqueratinas
title Non-Secretory Multiple Myeloma with Patchy Marrow Involvement and Aberrant Cytokeratin Expression
spellingShingle Non-Secretory Multiple Myeloma with Patchy Marrow Involvement and Aberrant Cytokeratin Expression
Silva, Miguel
Fractures
Spontaneous
Keratins
Multiple Myeloma
Plasma Cells
Fraturas Espontâneas
Mieloma Múltiplo
Plasmócitos
Queratinas
title_short Non-Secretory Multiple Myeloma with Patchy Marrow Involvement and Aberrant Cytokeratin Expression
title_full Non-Secretory Multiple Myeloma with Patchy Marrow Involvement and Aberrant Cytokeratin Expression
title_fullStr Non-Secretory Multiple Myeloma with Patchy Marrow Involvement and Aberrant Cytokeratin Expression
title_full_unstemmed Non-Secretory Multiple Myeloma with Patchy Marrow Involvement and Aberrant Cytokeratin Expression
title_sort Non-Secretory Multiple Myeloma with Patchy Marrow Involvement and Aberrant Cytokeratin Expression
author Silva, Miguel
author_facet Silva, Miguel
Martins, Joana
Pinto, João
Amaro, Teresina
author_role author
author2 Martins, Joana
Pinto, João
Amaro, Teresina
author2_role author
author
author
dc.contributor.author.fl_str_mv Silva, Miguel
Martins, Joana
Pinto, João
Amaro, Teresina
dc.subject.por.fl_str_mv Fractures
Spontaneous
Keratins
Multiple Myeloma
Plasma Cells
Fraturas Espontâneas
Mieloma Múltiplo
Plasmócitos
Queratinas
topic Fractures
Spontaneous
Keratins
Multiple Myeloma
Plasma Cells
Fraturas Espontâneas
Mieloma Múltiplo
Plasmócitos
Queratinas
description Non-secretory multiple myeloma is a rare form of the disease that presents a diagnostic challenge. A 69-year-old woman presented to the emergency department with a pathological fracture of the right clavicle, along with a history of asthenia and middle back pain in the preceding three months. Workup revealed multiple focal lytic bone lesions in the clavicles, ribs, skull and thoracic- lumbar-sacral spine, without evidence of anemia, hypercalcemia or renal failure, with no abnormal immunofixation in the serum or urine and with normal serum free light chain ratios. The Iliac crest bone marrow aspiration and biopsy revealed a scarcely involved marrow, However, biopsy of one of the focal bone lesions revealed a hypercellular bone marrow with phenotypically abnormal plasmocytes, along with an intriguing, albeit aberrant, cytokeratin expression. Non-secretory multiple myeloma is in itself a rare diagnosis. However, the combination of a patchy marrow involvement and aberrant cytokeratin expression makes this a noteworthy presentation.
publishDate 2021
dc.date.none.fl_str_mv 2021-11-02
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13235
oai:ojs.www.actamedicaportuguesa.com:article/13235
url https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13235
identifier_str_mv oai:ojs.www.actamedicaportuguesa.com:article/13235
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13235
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13235/6435
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2021 Acta Médica Portuguesa
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Direitos de Autor (c) 2021 Acta Médica Portuguesa
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 34 No. 11 (2021): November; 778-781
Acta Médica Portuguesa; Vol. 34 N.º 11 (2021): Novembro; 778-781
1646-0758
0870-399X
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
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reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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