case_images: PMC10722259_01
case_images: Lumbar computed tomography (CT) showed (A, C, D) expansive bone destruction in the vertebrae and appendages of the 11th thoracic vertebra (white arrow), (B) accompanied by soft tissue mass formation and vertebral canal compression (black arrow).
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case_images: At day 1 after admission, the lumbar CT revealed expansive bone destruction in the vertebrae and appendages of the 11th thoracic vertebra and the first lumbar vertebra, bone cortex thinning, and local continuity interruption, accompanied by soft tissue mass formation and vertebral canal compression ( Figure 1 ).
case_images: Vertebra magnetic resonance imaging (MRI) and diffusion weighted imaging (DWI) showed multiple spotty abnormal signals in the cervical vertebra, thoracic vertebra, lumbar vertebra, and sacrum, which were both (A, D, G) low signal on T1-weighted imaging (white arrow) and (B, E, H, L) high signal on T2-weighted imaging and (C, F, I) fat suppression sequence (black arrow). DWI of vertebral showed (J) scattered high signals, and (K) they were low signals on corresponding apparent diffusion coefficient (ADC) imaging (thick white arrow).
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case_images: Multiple spotty abnormal signals were seen in the cervical vertebra, thoracic vertebra, lumbar vertebra, and sacrum by magnetic resonance imaging (MRI), which were both low signal on T1-weighted imaging and high signal on T2-weighted imaging, accompanied by mass formation in the 11th thoracic and first lumbar vertebrae and appendages ( Figure 2 ). Diffusion weighted imaging (DWI) of vertebral showed scattered high signals, and they were low signals on the corresponding apparent diffusion coefficient (ADC) imaging ( Figure 2 ).
case_images: Representative timelines of patient relevant data history.
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case_images: f3
case_images: Alkaline phosphatase (ALP) was normal ( Figure 3 ).
case_images: (A) hematoxylin and eosin (HE) staining showed coexistence of myeloma with clear cell renal cell carcinoma (CCRCC) in the lumbar spine. (B) Positive CD38 immunostaining was observed in myeloma (x200). (C) Positive multiple myeloma oncogene1 (MUM1) immunostaining was observed in myeloma (x200). (D) Positive kappa immunostaining was observed in myeloma (x200). (E) Negative lambda immunostaining was observed in myeloma (x200). (F) Positive carbonic anhydrases IX (CA-IX) immunostaining was observed in CCRCC (x200). (G) Positive cytokeratin-8 immunostaining was observed in myeloma (x200). (H) Positive Pax8 immunostaining was observed in myeloma (x200).
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case_images: PMC10722259_01_fendo-14-1206368-g004.jpg
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case_images: Pathological examination showed the coexistence of myeloma with CCRCC in hematoxylin and eosin (HE) staining ( Figure 4 ).