Multiple myeloma differential diagnosis: Difference between revisions
Jump to navigation
Jump to search
| Line 24: | Line 24: | ||
|} | |} | ||
*An important differential diagnosis is that of widespread bony metastases. Findings that favor the diagnosis of bony metastases over that of multiple myeloma include:<ref>Multiple myeloma. Radiopaedia (2015)http://radiopaedia.org/articles/multiple-myeloma-1 Accessed on September, 20th 2015</ref> | |||
:# Bone metastases more commonly affect the vertebral pedicles rather than vertebral bodies. | |||
:# Bone metastases rarely involve mandible and distal axial skeleton. | |||
:# Although both entities have variable bone scan appearances (both hot and cold) unlike multiple myeloma, extensive bony metastases rarely have a normal appearance. | |||
*Multiple myeloma must also be differentiated from other causes of bone pain and fever such as: | *Multiple myeloma must also be differentiated from other causes of bone pain and fever such as: | ||
Revision as of 21:10, 20 September 2015
|
Multiple myeloma Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Multiple myeloma differential diagnosis On the Web |
|
American Roentgen Ray Society Images of Multiple myeloma differential diagnosis |
|
Risk calculators and risk factors for Multiple myeloma differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Multiple myeloma must be differentiated from monoclonal gammopathy of undetermined significance(MGUS), isolated plasmacytoma of the bone, and extramedullary plasmacytoma.[1]
Differentiating Multiple Myeloma from other Diseases
- The table below summarizes how to differentiate multiple myeloma from other conditions that cause similar presentation:[2]
| Plasma Cell Neoplasm | M Protein Type | Pathology | Clinical Presentation |
| MGUS | IgG kappa or lambda; or IgA kappa or lambda | <10% plasma cells in bone marrow | Asymptomatic, with minimal evidence of disease (aside from the presence of an M protein) |
| Isolated plasmacytoma of bone | IgG kappa or lambda; or IgA kappa or gamma | Solitary lesion of bone; <10% plasma cells in marrow of uninvolved site | Asymptomatic or symptomatic |
| Extramedullary plasmacytoma | IgG kappa or lambda; or IgA kappa or gamma | Solitary lesion of soft tissue in the nasopharynx, tonsils, or sinuses | Asymptomatic or symptomatic |
| Multiple myeloma | IgG kappa or lambda; or IgA kappa or gamma | Often multiple lesions of bone | Symptomatic |
- An important differential diagnosis is that of widespread bony metastases. Findings that favor the diagnosis of bony metastases over that of multiple myeloma include:[3]
- Bone metastases more commonly affect the vertebral pedicles rather than vertebral bodies.
- Bone metastases rarely involve mandible and distal axial skeleton.
- Although both entities have variable bone scan appearances (both hot and cold) unlike multiple myeloma, extensive bony metastases rarely have a normal appearance.
- Multiple myeloma must also be differentiated from other causes of bone pain and fever such as:
- Waldenstrom Hypergammaglobulinemia
- Bone fracture
- Fibrous dysplasia
- Enchondroma
- Eosinophilic granuloma
- Giant cell tumor
- Osteoblastoma
- Aneurysmal bone cyst
- Solitary bone cyst
- Hyperparathyroidism
- Infection
- Chondroblastoma
- Chondromyxoid Fibroma
- Reactive plasmacytosis
- Macroglobulinemia
- Bone metastatic tumor
References
- ↑ "Myeloma - SEER Stat Fact Sheets". Retrieved 17 February 2014.
- ↑ "Myeloma - SEER Stat Fact Sheets". Retrieved 17 February 2014.
- ↑ Multiple myeloma. Radiopaedia (2015)http://radiopaedia.org/articles/multiple-myeloma-1 Accessed on September, 20th 2015