PMC5518520_01
Right lobe liver ultrasound (inferior view) showing innumerable hypoechoic heterogeneous masses, the largest of which was located inferiorly and measured 6.0 x 4.3 x 5.4 cm.
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Right upper quadrant ultrasound performed revealed innumerable hypoechoic hepatic masses (Figure 1).
CT of the abdomen showing numerous low attenuation lesions in the liver and spleen suspicious for metastatic disease along with soft tissue nodules in the anterior abdominal wall and numerous lytic lesions in the axial skeleton.
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CT of the chest and abdomen showed numerous low attenuation lesions in the liver and spleen suspicious for metastatic disease, along with soft tissue nodules in the anterior abdominal wall and a subpleural mass in the left upper lobe (Figures 2 and 3).
CT of the chest showing a subpleural mass in the upper left lobe that measured 3.3 x 3.0 x 2.7 cm concerning for metastasis.
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CT of the chest and abdomen showed numerous low attenuation lesions in the liver and spleen suspicious for metastatic disease, along with soft tissue nodules in the anterior abdominal wall and a subpleural mass in the left upper lobe (Figures 2 and 3).
Liver biopsy H&E stain demonstrating compact sheets of atypical plasma cells, consistent with extramedullary hepatic plasmacytoma.
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Biopsy of one of the hepatic lesions was consistent with extramedullary plasmacytoma (Figures 4-7).
Liver biopsy CD138 marker confirming neoplastic extramedullary plasma cell infiltration from multiple myeloma.
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Biopsy of one of the hepatic lesions was consistent with extramedullary plasmacytoma (Figures 4-7).
Liver biopsy stained for kappa light chain immunoglobulin confirming neoplastic extramedullary plasma cell infiltration from multiple myeloma.
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Biopsy of one of the hepatic lesions was consistent with extramedullary plasmacytoma (Figures 4-7).
Liver biopsy stained for lambda light chain immunoglobulin confirming neoplastic extramedullary plasma cell infiltration from multiple myeloma.
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fig7
Biopsy of one of the hepatic lesions was consistent with extramedullary plasmacytoma (Figures 4-7).