A 75-year-old female patient was admitted to Tenri Hospital for the progressive disturbance of consciousness. The hematological findings were as follows: Hb 8.1g/dl, Plt 45×103/μl, WBC 6600/μl. Seventy-four percent of bone marrow nucleated cells were immature plasmocyters which were positive only for cytoplasmic kappa chain by PAP staining. The laboratory data showed hypercalcemia (7.4 mEq/L), hyper-phosphatemia (6.9mg/dl ), increased serum creatinine (5.5mg/dl ), profuse urinary Bence Jones (k) protein (15g/day) and panhypogammaglobulinemia. Although the chest roentgenogram showed no abnormal shadows, a bone scintigraphy using 99m-Tc methylene diphosphonate disclosed uniform and intense accumulation of radioactivity in the lungs. The patient died 4 months after admission from pulmonary and renal failure. Autopsy disclosed metastatic calcification of interalveolar septa with secondary thickening of alveolar walls. According to the analysis of the references, hypercalcemia, hyperphosphatemia and renal failure were uniformly observed in the patients associated with multiple myeloma and diffuse pulmonary calcification. The survival of the patients ranged from 14 days to 6 months, indicating that pulmonary calcification is a serious complication of multiple myeloma.
