PMC6839014_01
I) Preoperative sagittal T1 weighted magnetic resonance imaging showing a hypointense lesion with dorsal extrusion in T5 and less than 50% vertebral body collapse.. II) Sagittal computed tomography scan showing expansile irregular osteolytic lesion of T5 vertebral body and involvement of the anterior and posterior wall.. III) Lateral thoracic radiography after decompression of T5 and dorsal instrumented stabilization of T4-T6.
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CT and MRI detected a single malignant osteolytic process of the spine involving T5 with a pathologic fracture leading to segmental kyphosis (Fig. 1).
Skeletal scintigraphy with 690MBq Tc-99m-DPD did not reveal any malignant or metastatic process.
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Skeletal scintigraphy (Fig. 2) and single photon emission computed tomography (SPECT) could not match the MRI findings.
Resected tumor tissue specimen.. I) CD138 positively stained specimen, marking a plasmacytic derivation (x40).. II) Masses of plasma cells (H&E, x40).. III) Immunhistological study stained negatively with anti lambda - light chain antibodies (x40).. IV) Immunhistological study stained positively with anti kappa - light chain antibodies (x40).
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Histopathologic findings revealed a plasma cell neoplasia type kappa (Fig. 3).