Learning objectives
Understandthe current role of interventional radiology in diagnosis of multiple myeloma.
Understand the role of interventional radiology in the treatment of multiple myeloma complications.
To be aware of the importance of the patient-radiologist and radiologist-clinician relationship.
Background
Multiple myeloma (MM) is a malignancy that is part of a spectrum of diseases ranging from monoclonal gammapathy of unknown significance (MGUS) to plasma cell leukemia (1).
MM si characterized by proliferation of malignant plasma cells and subsequent overabundance of monoclonal paraprotein (M protein).
MM can range from aymptomatic to severly symptomatic with complications requiering emergent treatment.
Signs and symptomes of MM include: Bone pain ,
pathologic fractures ,
spinal cord compression,
weakness,
bleeding,
infections,
hypercalcemia,
renal failure and neuropathies.
Definite diagnosis still requires bone...
Findings and procedure details
Diagnostic interventions
Revised International Myeloma Working Group diagnostic criteria for multiple myeloma
Clonal bone marrow plasma cells ≥10% or biopsy-proven bony or extramedullaryplasmacytoma and any one or more of the following myeloma defining events
Hypercalcaemia: serum calcium >0·25 mmol/L (>1 mg/dL) higher than the upper limit of normal or >2·75 mmol/L (>11 mg/dL)
Renal insufficiency: creatinine clearance <40 mL per min† or serum creatinine >177 µmol/L (>2 mg/dL)
Anaemia: haemoglobin value of >20 g/L below the lower limit of normal,
or a haemoglobin value <100...
Conclusion
Interventional radiology can be a helpful tool in the diagnosis of multiple myeloma as well as in the treatment of associated vertebral fractures,
helping to relieve pain and improving the quality of life of patients.
Personal information
Dr.
Santiago Carbullanca Resident in training.
Department of Radiology,
Hospital del Mar.
Passeig Marítim,
25-29,
08003 Barcelona,
Spain. Email:
[email protected]
References
1.-Medscape: Multiple Myeloma Updated: Dec 06,
2018 Author: Dhaval Shah,
MD; Chief Editor: Emmanuel C Besa,
MD.
2.-Rajkumar SV,
Dimopoulos MA,
Palumbo A,
Blade J,
Merlini G,
Mateos M-V,
etal.
International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma.
The lancet oncology.
2014;15(12):e538–e548.
3.-Štifter S,
Babarović E,
Valković T,
Seili-Bekafigo I,
Štemberger C,
Načinović A,
et al.
Combined evaluation of bone marrow aspirate and biopsy is superior in the prognosis of multiple myeloma.
Diagnostic pathology.
2010;5(1):30.
4.-Kumar SK,
Callander NS,
Alsina M,...