Lege Artis Medicinae

[Concomitant occurrence of multiple myeloma and diffuse large B-cell lymphoma]

RADVÁNYI Mónika, ILLÉS Árpád, MÉHES Gábor, KAJTÁR Béla, FAZAKAS Ferenc, GARAI Ildikó, GERGELY Lajos

OCTOBER 20, 2010

Lege Artis Medicinae - 2010;20(10)

[We report a case of a 50-year-old male patient, in whom the coexistence of multiple myeloma and diffuse large B cell lymphoma was confirmed. In December 2007, the patient was admitted to the department of internal medicine with fatigue resulting from mild anemia. A tumor of the left testis was discovered, and after semicastration diffuse large B cell lymphoma was diagnosed by histopathological analysis (clinical stage: II/EB). Examination of the bone marrow revealed a plasmocytic infiltrate of 60%, while 36.1 g/l IgG-kappa paraprotein was found in the peripheric blood, fulfilling the diagnostic criteria of multiple myeloma (Durie-Salmon stage: I). The patient received six cycles of rituximab- CHOP-21 chemotherapy for diffuse large B cell lymphoma. Following a transient improvement, the multiple myeloma showed progression, therefore we switched to VTD protocol (bortezomib, thalidomid, dexamethason). The patient underwent high dose chemotherapy and autologous hematopoietic stem cell transplantation. Both hematologic diseases showed complete remission. Both tumour samples were tested for immunoglobulin heavy-chain rearrangement by polymerase chain reaction and DNA sequence analysis, according to which the possibility for clonal relationship between multiple myeloma and diffuse large B cell lymphoma could not be confirmed.]

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