Massive splenomegaly as the presenting feature of multiple myeloma in an elderly man
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Date
2022-01
Journal Title
Journal ISSN
Volume Title
Publisher
The Indian Academy of Geriatrics
Abstract
A 70-year-old man presented with generalized weakness, easy fatigability, and early satiety of 2-month duration. On examination, he had severe pallor and massive splenomegaly. Hematological investigations revealed bicytopenia with hypergammaglobulinemia and acute kidney injury. Bone marrow aspiration cytology was suggestive of plasma cell dyscrasia. Monoclonal protein peak (due to heavy chain of IgG type) was found on serum protein electrophoresis, and lambda light chains and IgG heavy chains were elevated on immunofixation. The patient was diagnosed as a case of multiple myeloma and was started on bortezomib杔enalidomide杁examethasone regimen. After 7 months of chemotherapy, his spleen had regressed, and the patient had become asymptomatic. Presentation with massive splenomegaly is usually a feature of Waldenstrom抯 macroglobulinemia. However, rarely multiple myeloma may have extramedullary manifestations such as splenomegaly as the primary presenting feature.
Description
Keywords
Chemotherapy, extramedullary, plasma cell infiltration, Waldenstrom抯
Citation
Mishra Vaibhav, Pandey Abhishek, Goyal Deeksha, Chakrabarti Sankha Shubhra . Massive splenomegaly as the presenting feature of multiple myeloma in an elderly man. Journal of the Indian Academy of Geriatrics. 2022 Jan; 18(1): 37-39