Multiple myeloma differential diagnosis: Difference between revisions
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* | *Another 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 more commonly affect the vertebral pedicles rather than vertebral bodies. | ||
:# Bone metastases rarely involve mandible and distal axial skeleton. | :# 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. | :# 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 | *Multiple myeloma must also be differentiated from other causes of bone pain and fatigue such as: | ||
:* [[Waldenström's macroglobulinemia|Waldenstrom Hypergammaglobulinemia]] | :* [[Waldenström's macroglobulinemia|Waldenstrom Hypergammaglobulinemia]] | ||
:* [[Bone fracture]] | :* [[Bone fracture]] | ||
Revision as of 21:12, 20 September 2015
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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 |
- Another 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 fatigue 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