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Multiple Myeloma, Craniovertebral Junction
Cheryl A. Petersilge, MD, MBA
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Multiple myeloma (MM)
          • Synonyms

            • Plasma cell myeloma
          • Definitions

            • Heterogeneous group of plasma cell neoplasms involving primarily bone marrow ± soft tissues
            • Plasmacytoma: Solitary tumor in bone or soft tissue

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                • Laboratory Analysis

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              • Reporting Tips

                                                Selected References

                                                1. Mavrogenis AF et al: Tumours of the atlas and axis: a 37-year experience with diagnosis and management. Radiol Med. 117(4):616-35, 2012
                                                2. Hanrahan CJ et al: Current concepts in the evaluation of multiple myeloma with MR imaging and FDG PET/CT. Radiographics. 30(1):127-42, 2010
                                                3. Huang W et al: Solitary plasmacytoma of cervical spine: treatment and prognosis in patients with neurological lesions and spinal instability. Spine (Phila Pa 1976). 35(8):E278-84, 2010
                                                4. Bartel TB et al: F18-fluorodeoxyglucose positron emission tomography in the context of other imaging techniques and prognostic factors in multiple myeloma. Blood. 114(10):2068-76, 2009
                                                5. Bäuerle T et al: Multiple myeloma and monoclonal gammopathy of undetermined significance: importance of whole-body versus spinal MR imaging. Radiology. 252(2):477-85, 2009
                                                6. Dimopoulos M et al: International myeloma working group consensus statement and guidelines regarding the current role of imaging techniques in the diagnosis and monitoring of multiple Myeloma. Leukemia. 23(9):1545-56, 2009
                                                7. Dinter DJ et al: Comparison of whole-body MR imaging and conventional X-ray examination in patients with multiple myeloma and implications for therapy. Ann Hematol. 88(5):457-64, 2009
                                                8. Mont'Alverne F et al: Percutaneous vertebroplasty for multiple myeloma of the cervical spine. Neuroradiology. 51(4):237-42, 2009
                                                9. Shortt CP et al: Whole-Body MRI versus PET in assessment of multiple myeloma disease activity. AJR Am J Roentgenol. 192(4):980-6, 2009
                                                10. Weininger M et al: Whole-body MRI of multiple myeloma: comparison of different MRI sequences in assessment of different growth patterns. Eur J Radiol. 69(2):339-45, 2009
                                                11. Kyle RA et al: Multiple myeloma. Blood. 111(6):2962-72, 2008
                                                12. D'Sa S et al: Guidelines for the use of imaging in the management of myeloma. Br J Haematol. 137(1):49-63, 2007
                                                13. Kyle RA et al: Epidemiology of the plasma-cell disorders. Best Pract Res Clin Haematol. 20(4):637-64, 2007
                                                14. Walker R et al: Magnetic resonance imaging in multiple myeloma: diagnostic and clinical implications. J Clin Oncol. 25(9):1121-8, 2007
                                                15. Durie BG: The role of anatomic and functional staging in myeloma: description of Durie/Salmon plus staging system. Eur J Cancer. 42(11):1539-43, 2006
                                                16. Ghanem N et al: Whole-body MRI in the detection of bone marrow infiltration in patients with plasma cell neoplasms in comparison to the radiological skeletal survey. Eur Radiol. 16(5):1005-14, 2006
                                                17. Rao G et al: Multiple myeloma of the cervical spine: treatment strategies for pain and spinal instability. J Neurosurg Spine. 5(2):140-5, 2006
                                                18. Greipp PR et al: International staging system for multiple myeloma. J Clin Oncol. 2005 May 20;23(15):3412-20. Epub 2005 Apr 4. Erratum in: J Clin Oncol. 23(25):6281, 2005
                                                19. Jadvar H et al: Diagnostic utility of FDG PET in multiple myeloma. Skeletal Radiol. 31(12):690-4, 2002
                                                20. Mahnken AH et al: Multidetector CT of the spine in multiple myeloma: comparison with MR imaging and radiography. AJR Am J Roentgenol. 178(6):1429-36, 2002
                                                21. Schirrmeister H et al: Initial results in the assessment of multiple myeloma using 18F-FDG PET. Eur J Nucl Med Mol Imaging. 29(3):361-6, 2002
                                                22. Zaidi AA et al: Multiple myeloma: an old disease with new hope for the future. CA Cancer J Clin. 51(5):273-85; quiz 286-9, 2001
                                                23. Lecouvet FE et al: Skeletal survey in advanced multiple myeloma: radiographic versus MR imaging survey. Br J Haematol. 106(1):35-9, 1999
                                                24. Lecouvet FE et al: Vertebral compression fractures in multiple myeloma. Part I. Distribution and appearance at MR imaging. Radiology. 204(1):195-9, 1997
                                                25. Singer CR: ABC of clinical haematology. Multiple myeloma and related conditions. BMJ. 314(7085):960-3, 1997
                                                26. Moulopoulos LA et al: Multiple myeloma: MR patterns of response to treatment. Radiology. 193(2):441-6, 1994
                                                27. Rahmouni A et al: Detection of multiple myeloma involving the spine: efficacy of fat-suppression and contrast-enhanced MR imaging. AJR Am J Roentgenol. 160(5):1049-52, 1993
                                                28. Libshitz HI et al: Multiple myeloma: appearance at MR imaging. Radiology. 182(3):833-7, 1992
                                                29. Moulopoulos LA et al: Multiple myeloma: spinal MR imaging in patients with untreated newly diagnosed disease. Radiology. 185(3):833-40, 1992
                                                30. Resnick D et al: Plasma-cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes: the POEMS syndrome. Distinctive radiographic abnormalities. Radiology. 140(1):17-22, 1981
                                                31. Woolfenden JM et al: Comparison of bone scintigraphy and radiography in multiple myeloma. Radiology. 134(3):723-8, 1980
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Clinical Issues

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Multiple myeloma (MM)
                                                        • Synonyms

                                                          • Plasma cell myeloma
                                                        • Definitions

                                                          • Heterogeneous group of plasma cell neoplasms involving primarily bone marrow ± soft tissues
                                                          • Plasmacytoma: Solitary tumor in bone or soft tissue

                                                        IMAGING

                                                        • General Features

                                                          • Radiographic Findings

                                                            • CT Findings

                                                              • MR Findings

                                                                • Nuclear Medicine Findings

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Staging, Grading, & Classification

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              • Laboratory Analysis

                                                                                CLINICAL ISSUES

                                                                                • Presentation

                                                                                  • Demographics

                                                                                    • Natural History & Prognosis

                                                                                      • Treatment

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Consider

                                                                                          • Image Interpretation Pearls

                                                                                            • Reporting Tips

                                                                                              Selected References

                                                                                              1. Mavrogenis AF et al: Tumours of the atlas and axis: a 37-year experience with diagnosis and management. Radiol Med. 117(4):616-35, 2012
                                                                                              2. Hanrahan CJ et al: Current concepts in the evaluation of multiple myeloma with MR imaging and FDG PET/CT. Radiographics. 30(1):127-42, 2010
                                                                                              3. Huang W et al: Solitary plasmacytoma of cervical spine: treatment and prognosis in patients with neurological lesions and spinal instability. Spine (Phila Pa 1976). 35(8):E278-84, 2010
                                                                                              4. Bartel TB et al: F18-fluorodeoxyglucose positron emission tomography in the context of other imaging techniques and prognostic factors in multiple myeloma. Blood. 114(10):2068-76, 2009
                                                                                              5. Bäuerle T et al: Multiple myeloma and monoclonal gammopathy of undetermined significance: importance of whole-body versus spinal MR imaging. Radiology. 252(2):477-85, 2009
                                                                                              6. Dimopoulos M et al: International myeloma working group consensus statement and guidelines regarding the current role of imaging techniques in the diagnosis and monitoring of multiple Myeloma. Leukemia. 23(9):1545-56, 2009
                                                                                              7. Dinter DJ et al: Comparison of whole-body MR imaging and conventional X-ray examination in patients with multiple myeloma and implications for therapy. Ann Hematol. 88(5):457-64, 2009
                                                                                              8. Mont'Alverne F et al: Percutaneous vertebroplasty for multiple myeloma of the cervical spine. Neuroradiology. 51(4):237-42, 2009
                                                                                              9. Shortt CP et al: Whole-Body MRI versus PET in assessment of multiple myeloma disease activity. AJR Am J Roentgenol. 192(4):980-6, 2009
                                                                                              10. Weininger M et al: Whole-body MRI of multiple myeloma: comparison of different MRI sequences in assessment of different growth patterns. Eur J Radiol. 69(2):339-45, 2009
                                                                                              11. Kyle RA et al: Multiple myeloma. Blood. 111(6):2962-72, 2008
                                                                                              12. D'Sa S et al: Guidelines for the use of imaging in the management of myeloma. Br J Haematol. 137(1):49-63, 2007
                                                                                              13. Kyle RA et al: Epidemiology of the plasma-cell disorders. Best Pract Res Clin Haematol. 20(4):637-64, 2007
                                                                                              14. Walker R et al: Magnetic resonance imaging in multiple myeloma: diagnostic and clinical implications. J Clin Oncol. 25(9):1121-8, 2007
                                                                                              15. Durie BG: The role of anatomic and functional staging in myeloma: description of Durie/Salmon plus staging system. Eur J Cancer. 42(11):1539-43, 2006
                                                                                              16. Ghanem N et al: Whole-body MRI in the detection of bone marrow infiltration in patients with plasma cell neoplasms in comparison to the radiological skeletal survey. Eur Radiol. 16(5):1005-14, 2006
                                                                                              17. Rao G et al: Multiple myeloma of the cervical spine: treatment strategies for pain and spinal instability. J Neurosurg Spine. 5(2):140-5, 2006
                                                                                              18. Greipp PR et al: International staging system for multiple myeloma. J Clin Oncol. 2005 May 20;23(15):3412-20. Epub 2005 Apr 4. Erratum in: J Clin Oncol. 23(25):6281, 2005
                                                                                              19. Jadvar H et al: Diagnostic utility of FDG PET in multiple myeloma. Skeletal Radiol. 31(12):690-4, 2002
                                                                                              20. Mahnken AH et al: Multidetector CT of the spine in multiple myeloma: comparison with MR imaging and radiography. AJR Am J Roentgenol. 178(6):1429-36, 2002
                                                                                              21. Schirrmeister H et al: Initial results in the assessment of multiple myeloma using 18F-FDG PET. Eur J Nucl Med Mol Imaging. 29(3):361-6, 2002
                                                                                              22. Zaidi AA et al: Multiple myeloma: an old disease with new hope for the future. CA Cancer J Clin. 51(5):273-85; quiz 286-9, 2001
                                                                                              23. Lecouvet FE et al: Skeletal survey in advanced multiple myeloma: radiographic versus MR imaging survey. Br J Haematol. 106(1):35-9, 1999
                                                                                              24. Lecouvet FE et al: Vertebral compression fractures in multiple myeloma. Part I. Distribution and appearance at MR imaging. Radiology. 204(1):195-9, 1997
                                                                                              25. Singer CR: ABC of clinical haematology. Multiple myeloma and related conditions. BMJ. 314(7085):960-3, 1997
                                                                                              26. Moulopoulos LA et al: Multiple myeloma: MR patterns of response to treatment. Radiology. 193(2):441-6, 1994
                                                                                              27. Rahmouni A et al: Detection of multiple myeloma involving the spine: efficacy of fat-suppression and contrast-enhanced MR imaging. AJR Am J Roentgenol. 160(5):1049-52, 1993
                                                                                              28. Libshitz HI et al: Multiple myeloma: appearance at MR imaging. Radiology. 182(3):833-7, 1992
                                                                                              29. Moulopoulos LA et al: Multiple myeloma: spinal MR imaging in patients with untreated newly diagnosed disease. Radiology. 185(3):833-40, 1992
                                                                                              30. Resnick D et al: Plasma-cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes: the POEMS syndrome. Distinctive radiographic abnormalities. Radiology. 140(1):17-22, 1981
                                                                                              31. Woolfenden JM et al: Comparison of bone scintigraphy and radiography in multiple myeloma. Radiology. 134(3):723-8, 1980