Nonsecretory myeloma. A case report.

While the entity of nonsecretory myeloma is rare, its diagnosis may be delayed or remain undetected if too much reliance is placed on the presence of a serum or urinary M component, which traditionally has been considered an important, if not essential, feature of plasma cell myelomatosis. Nonsecretory myeloma is characterized radiographically by the presence of classic osteolytic lesions. Laboratory studies reveal anemia, hypogammaglobulinemia, and/or the failure to demonstrate a monoclonal immunoglobulin or Bence Jones protein on repeated electrophoretic analysis. Bone marrow aspirates reveal the presence of cytologically documented myeloma cells.