Korean J Lab Med.  2010 Aug;30(4):334-338. 10.3343/kjlm.2010.30.4.334.

A Case of Central Nervous System Myelomatosis with Complex Chromosome Aberrations

• Bang HI
• Yoo JY
• Kim KH
• Park R
• Shin JW
• Choi TY
• Lee SC
• Park HS
• Won JH

• KMID: 1781637
• DOI: http://doi.org/10.3343/kjlm.2010.30.4.334

Abstract

Involvement of the central nervous system is very uncommon in multiple myeloma, observed in approximately 1% of the multiple myeloma patients. We report a case of central nervous system myelomatosis with complex chromosome aberrations in a 62-yr-old female patient, who had previously been diagnosed as multiple myeloma. Fluorescent in situ hybridization revealed 13q deletion, p53 gene deletion and IGH/FGFR3 rearrangement and chromosomal study showed complex chromosome aberrations. After four cycles of chemotherapy, the patient was admitted to the hematology department with severe headache. Plasma cells were found in the cerebrospinal fluid (CSF), and CSF immunoelectrophoresis revealed abnormal precipitin arcs against anti-IgG and anti-lambda antisera. She was given systemic chemotherapy and eight courses of intrathecal chemotherapy, which cleared plasma cells in the CSF. Two months later, she was given autologous stem cell transplantation. Three months after stem cell transplantation, central nervous system myelomatosis progressed to plasma cell leukemia and two months later,the patient expired.

Keyword

Cerebrospinal fluid; Plasma cells; Immunoelectrophoresis; Chromosome aberrations

MeSH Terms

Antineoplastic Agents/therapeutic use
Central Nervous System Neoplasms/*diagnosis/drug therapy/genetics
Cerebrospinal Fluid/cytology
*Chromosome Deletion
Combined Modality Therapy
Disease Progression
Female
Gene Deletion
Humans
Immunoelectrophoresis
In Situ Hybridization, Fluorescence
Leukemia, Plasma Cell/diagnosis
Middle Aged
Multiple Myeloma/*diagnosis/drug therapy/genetics
Plasma Cells/pathology
Precipitins/metabolism
Receptor, Fibroblast Growth Factor, Type 3/genetics
Stem Cell Transplantation
*Translocation, Genetic
Transplantation, Autologous
Tumor Suppressor Protein p53/genetics

Figure

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  Fig. 1. Serum (A) and cerebrospinal fluid (B) protein immunoelectrophoresis showing abnormal precipitin arcs against anti-IgG and anti-lambda antisera.

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  Fig. 2. Cyto-centrifuge preparation of cerebrospinal fluid showing myeloma cells (Wright-Giemsa stain, ×400).

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