A Case of Nonsecretory Multiple Myeloma with Atypical Imaging Features

Abstract

Multiple myeloma usually shows homogeneous enhancement on contrast-enhanced Magnetic Resonance imaging (MRI), and is accompanied by a monoclonal gammopathy in serum or urine. We report a case of nonsecretory myeloma, the diagnosis was difficult due to the absence of a monoclonal gammopathy and the presence of atypical imaging features.

Comparison of clinical and laboratory characteristics of nonsecretory multiple myeloma and secretory multiple myeloma in a tertiary care hospital

“…In some previous reports, osteolytic lesions were considered a critical sign for NSM diagnosis 22,23 …”

“…In some previous reports, osteolytic lesions were considered a critical sign for NSM diagnosis. 22,23 Patients with NSM usually report bone pain on developing osteolytic lesions. Approximately 88% of patients with NSM in the present study had bone lesions F I G U R E 1 Immunophenotyping of the bone marrow aspirate obtained from patients with nonsecretory myeloma determined by flow cytometry.…”

A Patient of Multiple Myeloma with Absent M-spike on Serum Protein Electrophoresis and Elevated Serum-Free Light Chains: A Case Report and Literature Review

“…The producer type as the name suggests can synthesize immunoglobulin by the plasma cells but is unable to secrete it. The other non-producer type of NSM fails to produce the immunoglobulin at all [5]. Fewer cases of NSM will be reported if serum or urine is more accurately tested for traces of M protein.…”