Abstract
M ULTIPLE MYELOMA is a neoplastic proliferation of plasma cells, generally originating in the bone marrow. These globulin-producing plasma cells may be immature (myeloma cells). Most of the clinical features are due to marrow infiltration and bone destruction by plasma cells. Multiple myeloma is most common in patients between 45 and 70 yr of age. The disease is characterized by bone pain, particularly in the back (with or without pathologic fracture), weakness, soft-tissue masses, renal insufficiency, neurologic symptoms, and frequent infections.“r6 Abnormal laboratory findings include anemia, hyperglobulinemia, hypercalcemia and hyperuricemia. The alkaline phosphatase is typically normal in uncomplicated cases. Serum or urine electrophoresis shows a characteristic M-type protein peak, and bone marrow study reveals an increase in plasma or myeloma cells.24 The natural history of myeloma is undergoing constant study.” The abnormal electrophoretic changes and even plasma cell proliferation in the marrow may be present for a long period before clinical or radiologic evidence of disease is found. Radiographically, the typical myeloma shows multiple small osteolytic lesions with sharp punched-out margins (Fig. 1). However, the roentgen appearance is extremely variable (Table l), and these variations will be emphasized in the following discussion.
Published Version
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