Osteolytic Lesions: An Unexpected Diagnosis
Pedro Mesquita, Diogo Ferreira da Silva, Sofia Mateus, Teresa Maria Costa, Luís Ferrão Vale
TL;DR
A patient with back pain and kidney issues was diagnosed with a rare lymphoma after initial tests suggested multiple myeloma.
Contribution
Highlights the diagnostic challenge of atypical lymphoma presentations mimicking multiple myeloma.
Findings
The patient presented with hypercalcemia and kidney failure, typical of multiple myeloma.
Bone marrow biopsy confirmed a diagnosis of diffuse large B-cell lymphoma instead of myeloma.
This case emphasizes the need for thorough evaluation in atypical presentations.
Abstract
This is the case of a patient who went to the emergency department with back pain and constitutional symptoms (weight loss, anorexia, nausea) lasting one month. Blood tests revealed hypercalcemia and new-onset kidney failure that prompted admission for study. Bone X-ray revealed multiple lytic lesions, and myeloma screening was negative. After a bone marrow biopsy guided by ultrasound of one lesion, it was possible to obtain the diagnosis of diffuse large B-cell lymphoma. We present this case for the diagnostic challenge and atypical presentation simulating multiple myeloma with hypercalcemia.
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Taxonomy
TopicsSarcoma Diagnosis and Treatment · Soft tissue tumor case studies · Cancer Diagnosis and Treatment