CTICasesExtramedullary Myeloma (Pulmonary Infiltration)
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Imaging findings
Radiograph and CT show patchy lung consolidation with numerous nodules and ground glass opacities, as well as large patches, particularly below the hilum. Lymphadenopathy is present in the subcarinal and pre-tracheal regions, and possible mucus in the airways.
Key takeaways
In a patient with multiple myeloma post-bone marrow transplantation, these widespread lung findings were determined by lavage and biopsy to be extramedullary myeloma, specifically plasma cell infiltration of the lungs, with no evidence of infection or lymphoma. This highlights an unusual and florid presentation of plasma cell disease outside of the bone marrow, which can be challenging to differentiate from opportunistic infections in immunocompromised patients.
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