Osteolytic-variant POEMS syndrome: an uncommon presentation of 'osteosclerotic' myeloma
| Autor: | Katrina N. Glazebrook, Stephen M. Broski, Benjamin M. Howe, Michelle M Mauermann, Michael S. Clark |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Radiography Periosteal reaction Bone Neoplasms Bone and Bones Organomegaly 030218 nuclear medicine & medical imaging Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Fluorodeoxyglucose F18 Positron Emission Tomography Computed Tomography medicine Humans Radiology Nuclear Medicine and imaging Aged POEMS syndrome Fluorodeoxyglucose PET-CT medicine.diagnostic_test business.industry Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging 030220 oncology & carcinogenesis POEMS Syndrome Radiology Radiopharmaceuticals medicine.symptom business Polyneuropathy medicine.drug |
| Zdroj: | Skeletal Radiology. 46:817-823 |
| ISSN: | 1432-2161 0364-2348 |
| Popis: | Polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (POEMS) syndrome, a form of osteosclerotic myeloma, is a multisystem disease related to a monoclonal plasma cell proliferative disorder. Osseous lesions are most commonly sclerotic on radiographs and computed tomography (CT), demonstrate low T1 and T2 signal intensity on magnetic resonance imaging (MRI), and have variable degrees of avidity on positon emission tomography (PET) imaging using 18-fluorodeoxyglucose (18F-FDG). We present three cases of POEMS syndrome manifesting as osteolytic lesions with indolent features, including well-defined thin sclerotic rims, no cortical disruption or periosteal reaction, no associated soft-tissue mass, and a periarticular location, all features that could lead to misinterpretation as benign bone lesions. We also report increased T1 signal and diffuse solid enhancement of these lesions on MRI, features previously unreported. POEMS syndrome should not be discounted as a diagnostic consideration in the setting of osteolytic lesions with non-aggressive imaging characteristics on radiographs or CT, especially in the presence of other supportive clinical features. |
| Databáze: | OpenAIRE |
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