Multiple Myeloma is a neoplasm of B cell lineage characterized by excessive proliferation of abnormal plasma cells. It is characterized by a clinical pentad of 1) anemia, 2) a monoclonal protein in the serum or the urine or both, 3) bone leisons and or bone pain, 4) hypercalcemia >11.5g/dl and 5) renal insufficiency. Non secretory multiple myeloma is a rare variant of the classic form of multiple myeloma and accounts for 1% to 5 % of all cases of multiple myeloma. The clinical presentation and radiographic findings of non-secretory multiple myeloma and multiple myeloma are the same. The diagnosis of multiple myeloma requires the demonstration of monoclonal gammopathy in the serum or urine. In non-secretory multiple myeloma, however no such gammopathy can be demonstrated, making the diagnosis more difficult. We describe a 60 year old woman who initially presented with back pain which when further investigated by complete blood count revealed hemoglobin of 13g/dl, Total Leukocyte Count of 10,890 and platelet count of 1.5 lac/cmm. Viral markers revealed HCV positive. Hypercalcemia with a serum calcium level of 12.5g/dl was also demonstrated. MRI revealed multiple lytic bony lesions. No monoclonal gammopathy was found in the serum or urine and bone marrow biopsy showed marked plasmacytosis of > 45%. We present a case of Non Secretory multiple myeloma because of its illusive nature and rare entity.
Highlights
Multiple Myeloma is a neoplasm of B cell lineage.
Non secretory multiple myeloma is a rare variant of the classic form of multiple myeloma and accounts for 1% to 5 % of all cases of multiple myeloma.
No gammopathy in the urine in non secretory multiple myeloma.
Puri,A. , Wadhwa,H. and Singh,N. (2018). Non Secretory Multiple Myeloma With HCV Infection: A Rare Case Entity. Iranian Journal of Pathology, 13(2), 281-284. doi: 10.30699/ijp.13.2.281
MLA
Puri,A. , , Wadhwa,H. , and Singh,N. . "Non Secretory Multiple Myeloma With HCV Infection: A Rare Case Entity", Iranian Journal of Pathology, 13, 2, 2018, 281-284. doi: 10.30699/ijp.13.2.281
HARVARD
Puri A., Wadhwa H., Singh N. (2018). 'Non Secretory Multiple Myeloma With HCV Infection: A Rare Case Entity', Iranian Journal of Pathology, 13(2), pp. 281-284. doi: 10.30699/ijp.13.2.281
CHICAGO
A. Puri, H. Wadhwa and N. Singh, "Non Secretory Multiple Myeloma With HCV Infection: A Rare Case Entity," Iranian Journal of Pathology, 13 2 (2018): 281-284, doi: 10.30699/ijp.13.2.281
VANCOUVER
Puri A., Wadhwa H., Singh N. Non Secretory Multiple Myeloma With HCV Infection: A Rare Case Entity. Iran J Pathol, 2018; 13(2): 281-284. doi: 10.30699/ijp.13.2.281
