Pathological bone fractures in a 20-year old athletic male with multifocal solitary plasmacytoma of bone
✍ Scribed by Evan Kulbacki; Endi Wang*
- Publisher
- John Wiley and Sons
- Year
- 2011
- Tongue
- English
- Weight
- 195 KB
- Volume
- 87
- Category
- Article
- ISSN
- 0361-8609
No coin nor oath required. For personal study only.
✦ Synopsis
The patient is a 20-year male who presented for neck pain 2 weeks after he fell while playing football. Commuted tomography (CT) scans revealed a lytic and expansile lesion of the right lateral C1 vertebrae with a linear fracture (Image 1A). The magnetic resonance imaging (MRI) demonstrated a diffuse signal abnormality consistent with a pathologic fracture (Image 1B). After an inconclusive fine needle aspirate examination, the radiological findings were reviewed, and the lesion was thought to be likely an aneurysmal bone cyst. The vertebral fracture was thereafter repaired with a C3 to occiput fusion (Image 1B, inset) without a hematology referral. Approximately 15 months after Image 1. Pathological bone fractures caused by multifocal solitary plasmacytoma of bone. A. Horizontal section of CT scan of the neck showing a lytic lesion with a linear fracture of C1 vertebrae (arrow). B. Coronal section of MRI scan showing a diffuse signal abnormality consistent with pathological fracture (arrow) and surgical repair (Inset). C. CT scan showing a large lytic acetabular lesion of right hip (arrow). D. Histological and immunohistochemical studies of right acetabular lesion biopsy showing sheets of plasma cells (D1, H&E stain) which are positive for CD138 (D2) and kappa light chain (D3), but are negative for lambda light chain (D4). E. Urine protein electrophoresis showing Bence Jones protein in gamma region (shaded peak area).