Trenker Corinna, Görg Christian, Burchert Andreas, Westhoff Christina C, Safai Zadeh Ehsan, Dietrich Christoph F, Findeisen Hajo, Mann Christoph
Department of Hematology and Oncology, University Hospital Marburg, Germany.
Department of Gastroenterology, Interdisciplinary Ultrasound Center, University Hospital Marburg, Germany.
J Ultrason. 2025 May 8;25(101):20250015. doi: 10.15557/jou.2025.0015. eCollection 2025 Apr.
In patients with multiple myeloma, extramedullary myeloma manifestations can occur alongside bone marrow infiltration and osseous involvement. The aim of this study was to describe extramedullary myeloma manifestations using B-mode ultrasound and contrast-enhanced ultrasound.
Between February 2006 and 2021, a total of 21 patients with multiple myeloma and histologically or clinically proven extramedullary myeloma manifestations ( = 24) were included. All patients underwent B-mode ultrasound and contrast-enhanced ultrasound of extramedullary myeloma manifestations. B-mode ultrasound patterns of location, size border characteristics, and echogenicity (hypoechoic/isoechoic or hyperechoic) as well as contrast-enhanced ultrasound enhancement (hyper-, iso-, or hypoenhancement) were analyzed.
In most cases, extramedullary myeloma manifestations were located in the chest wall ( = 11; 45.8%). In all 24 cases, extramedullary myeloma manifestations were hypoechoic on B-mode ultrasound. = 16 (66.6%) of extramedullary myeloma manifestations had smooth and = 8 (33.3%) had irregular borders. The mean lesion size was 5.4 cm. On contrast-enhanced ultrasound, extramedullary myeloma manifestations presented arterial hyper- ( = 20; 83.3%) or isoenhancement ( = 4; 16.7%) followed by parenchymal iso- ( = 1; 4.2%) or hypoenhancement ( = 23; 95.8%). In molecular genetic analysis, every patient with reliable FISH results tested positive for at least one aberration considered "high-risk".
Extramedullary myeloma manifestations were typically hypoechoic on B-mode ultrasound. On contrast-enhanced ultrasound, they presented characteristic arterial hyperenhancement followed by parenchymal washout. All patients studied for the genetic risk status were found to be "high-risk".
在多发性骨髓瘤患者中，髓外骨髓瘤表现可与骨髓浸润和骨受累同时出现。本研究的目的是使用B型超声和超声造影描述髓外骨髓瘤表现。
2006年2月至2021年期间，共纳入21例有多发性骨髓瘤且经组织学或临床证实有髓外骨髓瘤表现（n = 24）的患者。所有患者均接受了髓外骨髓瘤表现的B型超声和超声造影检查。分析了B型超声的位置、大小、边界特征和回声性（低回声/等回声或高回声）模式以及超声造影增强情况（高增强、等增强或低增强）。
在大多数情况下，髓外骨髓瘤表现位于胸壁（n = 11；45.8%）。在所有24例中，髓外骨髓瘤表现在B型超声上均为低回声。16例（66.6%）髓外骨髓瘤表现边界光滑，8例（33.3%）边界不规则。病变平均大小为5.4 cm。在超声造影上，髓外骨髓瘤表现为动脉期高增强（n = 20；83.3%）或等增强（n = 4；16.7%），随后实质期等增强（n = 1；4.2%）或低增强（n = 23；95.8%）。在分子遗传学分析中，每例有可靠荧光原位杂交（FISH）结果的患者至少检测出一种被认为是“高危”的畸变呈阳性。
髓外骨髓瘤表现在B型超声上通常为低回声。在超声造影上，它们表现为特征性的动脉期高增强，随后实质期消退。所有研究基因风险状态的患者均被发现为“高危”。
