“Myeloma lung”—A previously unreported complication of multiple myeloma

Chejfec, Gregorio; Natarelli, Joseph; Gould, Victor E.

doi:10.1016/s0046-8177(83)80008-2

Cited by 16 publications

(6 citation statements)

References 4 publications

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“…11 In addition, only a few cases with histologically proven pulmonary involvement have been reported in the literature. [12][13][14][15][16][17][18] These findings suggest that the histological diagnosis of pulmonary involvement in myeloma is extremely difficult, particularly after bortezomib treatment, as in the present case. In patients with multiple myeloma who manifest abnormal pulmonary shadowing, pulmonary involvement from myeloma cells may be possible; therefore, lower doses of bortezomib should be initially administered to avoid severe DAH.…”

Section: Discussionsupporting

confidence: 53%

Early-Onset Severe Diffuse Alveolar Hemorrhage after Bortezomib Administration Suggestive of Pulmonary Involvement of Myeloma Cells

Sugita

Ohwada

Nagao

et al. 2015

J Clin Exp Hematopathol

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Severe acute lung injury is a rare but life-threatening complication associated with bortezomib. We report a patient with multiple myeloma who developed a severe diffuse alveolar hemorrhage (DAH) immediately after the first bortezomib administration. The patient was suspected to have pulmonary involvement of myeloma, which caused DAH after rapidly eradicating myeloma cells in the lungs with bortezomib. Rechallenge with bortezomib was performed without recurrent DAH. In patients with multiple myeloma who manifest abnormal pulmonary shadow, we should be aware of early-onset severe DAH after bortezomib administration, which might be due to pulmonary involvement of myeloma cells.

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Section: Discussionsupporting

confidence: 53%

Early-Onset Severe Diffuse Alveolar Hemorrhage after Bortezomib Administration Suggestive of Pulmonary Involvement of Myeloma Cells

Sugita

Ohwada

Nagao

et al. 2015

J Clin Exp Hematopathol

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“…In a series of 958 patients with myeloma, 10% had pulmonary findings, but in only 1 case was plasma cell involvement demonstrated histologically, and the clinical course was suggestive of plasma cell involvement in only 3 other cases [1]. In the literature, there are additional cases of pulmonary involvement: some of these had advanced or treatment-refractory disease, like our patient [2-4], whereas in several cases, the lung was the initial site of presentation [5-8]. Likewise, skin involvement is rare, but this too has been reported [9,10].…”

Section: Discussionmentioning

confidence: 67%

Multiple Myeloma Involving Skin and Pulmonary Parenchyma after Autologous Stem Cell Transplantation

Yuan

Wieczorek²,

Green

et al. 2009

J Hematol Oncol

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“…However, it is said that LCCC was first reported by Löhlein in 1921 and published in a journal of pathology written in German [25]. In the published English literature, we retrieved 12 cases of LCCC confirmed by autopsy from 1949 to 1989 (one of the patients underwent renal biopsy before death) [25][26][27][28][29][30] and 27 cases of LCCC diagnosed by renal biopsy from 1987 to 2020 [31][32][33][34][35][36][37][38][39][40][41][42][43] (Table 2). Moreover, in two other papers, the authors mentioned that they also observed LCCC, but they did not provide detailed descriptions [44,45].…”

Section: Discussionmentioning

confidence: 99%

Two kinds of rare light chain cast nephropathy caused by multiple myeloma: case reports and literature review

Sun

Dong

et al. 2021

BMC Nephrol

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Background Light chain cast nephropathy (LCCN) is the most common renal disease caused by multiple myeloma (MM). In addition to ordinary light chain protein casts, there are a few rare casts with unique shapes, including light chain amyloid casts (LCAC) and light chain crystal casts (LCCC). Case presentations Here, we report two patients. Patient 1 is a 72-year-old man who was clinically diagnosed with MM and acute kidney injury (AKI). Pathological examination of a renal biopsy revealed that there were many amyloid casts in the distal tubules that had a lightly-stained central area and a deeply-stained burr-like edge. The marginal zone of the cast was positive for Congo red staining and contained numerous amyloid fibers, as observed by electron microscopy. No systemic amyloidosis was found. The patient received 4 courses of bortezomib-based chemotherapy, and then, his MM achieved partial remission. Patient 2 is a 57-year-old man who was also clinically diagnosed with MM and AKI. Pathological examination of a renal biopsy showed that there were many crystalline casts in the distal tubules that were fully or partially composed of crystals with different shapes, including rhomboid, needle, triangle, rectangle and other geometric shapes. Congo red staining was negative. Crystals were also detected in the urine of this patient. After 9 courses of treatment with a bortezomib-based regimen, his MM obtained complete remission and his renal function returned to normal. Conclusions LCAC and LCCC nephropathy caused by MM are two rare types of LCCN, and both have their own unique morphological manifestations. LCAC nephropathy may not be accompanied by systemic amyloidosis. The diagnosis of these two unique LCCNs must rely on renal biopsy pathology, and the discovery of urine crystals is of great significance for indicating LCCC nephropathy.

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“Myeloma lung”—A previously unreported complication of multiple myeloma

Cited by 16 publications

References 4 publications

Early-Onset Severe Diffuse Alveolar Hemorrhage after Bortezomib Administration Suggestive of Pulmonary Involvement of Myeloma Cells

Early-Onset Severe Diffuse Alveolar Hemorrhage after Bortezomib Administration Suggestive of Pulmonary Involvement of Myeloma Cells

Multiple Myeloma Involving Skin and Pulmonary Parenchyma after Autologous Stem Cell Transplantation

Two kinds of rare light chain cast nephropathy caused by multiple myeloma: case reports and literature review

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