PMC3375071_01
Axial PET/CT fusion image demonstrates a large, intensely FDG avid mass in the region of the pancreas (green arrow).
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fig1
The mass was in the region of the head and body of the pancreas with no definite pancreatic duct dilation (Figure 1).
Core biopsy of the abdominal mass demonstrating sheets of atypical plasma cells which were positive with monoclonal kappa light chain staining by immunoperoxidases stains. No staining was seen for lambda light chains. (H&E stain, 20x magnification).
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fig2
Biopsy confirmed multiple myeloma (Figure 2).
Contrast-enhanced axial CT image demonstrates a large homogeneously enhancing mass in the region of the pancreatic head which is causing compression of the distal common bile duct (red arrow).
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fig3
The patient was admitted to the hospital two months later for jaundice with an elevated direct bilirubin due to the pancreatic mass compressing the distal common bile duct (Figure 3).
Contrast-enhanced coronal CT image demonstrates an ill-defined mass in the porta hepatis causing compression of the portal vein and common bile duct (red arrow).
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fig4
The patient received additional palliative radiation therapy; however follow-up studies showed multiple new metastatic liver lesions as well as an infiltrative mass in the porta hepatis encasing the portal vein, common hepatic artery and gastroduodenal artery (Figure 4).