PMC9091408_01
(a) and (b) Plain radiographs with a L4 ivory vertebra. (c) and (d) CT scan showing sclerotic lesion in the L4 vertebra and iliac bone marked with arrows. (e) and (f) T2- and T1-weighted images sagittal sections of the lumbar spine showing hypointense signal changes suggesting sclerotic lesion in the L4 vertebra.
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F1
The patient was investigated with plain radiographs and MRI of the lumbar spine, which showed an osteosclerotic lesion in the L4 vertebra and iliac bone (Fig. 1).
Histopathology and immunohistochemistry images showing (a) CD38, (b) CD138, (c) lambda, and (d) MUM-1 positivity suggesting a diagnosis of multiple myeloma.
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F2
Immunohistochemistry of the bone core sample was positive for CD138, CD38, MUM-1, lambda light chains, and negative for kappa light chains suggesting the diagnosis of plasma cell dyscrasias producing lambda light chains (Fig. 2).