1974 Volume 15 Issue 9 Pages 1036-1041
A 57-year-old man was admitted on January in 1973, because of anemia and multiple subcutaneous nodules located at anterior chest wall.
The urinalysis gave negative tests for protein, the erythrocyte sedimentation rate was 13 mm/hr, hypoproteinemia and hypogammaglobulinemia were found. Biopsy of subcutaneous nodules and bone marrow revealed malignant plasmocytoid tumor by an ordinary and electron microscopic examination.
Immunoelectrophoretic analysis demonstrated a formation of M bow in IgD and λ chain, but IgG, IgA and IgM levels were all decreased. Concentrated urine was examined with Ouchterlony method, but no Bence Jones protein was detected.
Cyclophosphamide, prednisolone and melphalan were administrated with slight clinical improvement. However, subcutaneous nodules enlarged again. Eradiation of 60Co was carried out but patient expired 6 months after the onset of the disease.
Autopsy showed wide-spread myeloma cells throughout the body.
In this case, persistent negative Bence Jones protein and normal erythrocyte sedimentation rate were of special interest concerning the diagnosis of myeloma.
