Korean J Hematol.  1999 Aug;34(3):501-506.

A Case of Multiple Myeloma with Multiple Plasmacytomas pesented as Upper Airway and Esophageal Obstruction

• Yun SM
• Song HS
• Lee SS

Abstract

Herein, we report a case of multiple myeloma with multiple plasmacytomas of thyroid, lung, lymph nodes and adrenal gland, who presented as upper airway and esophageal obstruction with vocal cord palsy. An 80-year-old women complained of dysphagia, hoarseness and anterior neck mass. Ultrasonography of the neck showed huge inhomogeneous solid mass involving left thyroid lobe and isthmus with several lymphadenopathy along the both upper deep cervical chain. Chest CT scanning revealed 4x3 cm sized, low density mass in posterobasal segment of the right lower lobe with both lower paratracheal lymphadenopathy, and abdominal CT scanning revealed 4.5x4.5 cm sized round low density mass in left adrenal gland. Serum and urine electrophoresis was normal and immunofixation of serum and urine was negative. Bone marrow smear and a bone scintigram revealed no abnormality, but iliac bone marrow biopsy revealed infiltration of abnormal plasma cells. Histologic and immunohistochemical examinations of the thyroid and lung mass revealed monoclonal proliferation of plasma cells of kappa light chain. After local irradiation of the neck with parenteral dexamethasone injection, anterior neck mass was much diminished in size, but 2 weeks later she had a pneumonia with fatal outcome.

Keyword

Multiple myeloma; Multiple plasmacytoma; Thyroid; Lung; Adrenal gland; Lymph nodes; Upper airway obstruction; Esophageal obstruction; Vocal cord palsy

MeSH Terms

Adrenal Glands
Aged, 80 and over
Biopsy
Bone Marrow
Deglutition Disorders
Dexamethasone
Electrophoresis
Fatal Outcome
Female
Hoarseness
Humans
Lung
Lymph Nodes
Lymphatic Diseases
Multiple Myeloma*
Neck
Plasma Cells
Plasmacytoma*
Pneumonia
Thyroid Gland
Tomography, X-Ray Computed
Ultrasonography
Vocal Cord Paralysis
Dexamethasone