Immunoglobulin D-Lambda Type Multiple Myeloma Presenting with FDG-PET/CT Negative Bone Marrow Involvement

Hisanori Machida; Tsutomu Shinohara; Hiroyuki Hino; Mitsuteru Yoshida; Nobuo Hatakeyama; Yoshio Okano; Mami Inayama; Emiko Hosokawa; Shuichi Abe; Keishi Naruse; Yoshihito Iwahara; Fumitaka Ogushi

doi:10.2169/internalmedicine.50.5148

CASE REPORTS

Immunoglobulin D-Lambda Type Multiple Myeloma Presenting with FDG-PET/CT Negative Bone Marrow Involvement

Hisanori Machida, Tsutomu Shinohara, Hiroyuki Hino, Mitsuteru Yoshida, Nobuo Hatakeyama, Yoshio Okano, Mami Inayama, Emiko Hosokawa, Shuichi Abe, Keishi Naruse, Yoshihito Iwahara, Fumitaka Ogushi

Author information

Hisanori Machida
Division of Pulmonary Medicine, National Hospital Organization National Kochi Hospital, Japan
Tsutomu Shinohara
Department of Clinical Investigation, National Hospital Organization National Kochi Hospital, Japan
Hiroyuki Hino
Division of Respiratory Surgery, National Hospital Organization National Kochi Hospital, Japan
Mitsuteru Yoshida
Division of Respiratory Surgery, National Hospital Organization National Kochi Hospital, Japan
Nobuo Hatakeyama
Division of Pulmonary Medicine, National Hospital Organization National Kochi Hospital, Japan
Yoshio Okano
Division of Pulmonary Medicine, National Hospital Organization National Kochi Hospital, Japan
Mami Inayama
Division of Pulmonary Medicine, National Hospital Organization National Kochi Hospital, Japan
Emiko Hosokawa
Division of Pulmonary Medicine, National Hospital Organization National Kochi Hospital, Japan
Shuichi Abe
Division of Pulmonary Medicine, National Hospital Organization National Kochi Hospital, Japan
Keishi Naruse
Division of Pathology, National Hospital Organization National Kochi Hospital, Japan
Yoshihito Iwahara
Division of Internal Medicine, National Hospital Organization National Kochi Hospital, Japan
Fumitaka Ogushi
Division of Pulmonary Medicine, National Hospital Organization National Kochi Hospital, Japan

Keywords: IgD myeloma, FDG-PET/CT

JOURNAL OPEN ACCESS

2011 Volume 50 Issue 14 Pages 1483-1487

DOI https://doi.org/10.2169/internalmedicine.50.5148

Details

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.

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