[loured]

bone lesion

by loured on Fri Jul 15, 2011 9:16 pm

HI, maybe someone can give me advice I was found to have a 1.7 cm lesion in My pubic ramus on a mri. The radiologist stated in the report it could be a hemangioma or echodroma but ,metestic disease could not be ruled out based on exam alone. He recommended a bone scan. I went for a bone scan which was normal no lesion detected. I had an xray of the area which was also normal. My Dr ordered a SPEP which was also normal along with a CBC and CHEM panel. My Oncologist wants a CT scan with dye but My Hemotologist and GP said not necassary. I am concerned about a plasmacytoma. My hemotolgist said 99 pct of the time u would have a M spike and some other blood abnormality My GP agreed. Oncologist was not really concerned as wel,l said it was probably a hemangioma. The other Dr said the oncologist will always move toward biopsy which is not nec in My case. The finding was incidental I have a tear in My opposite hip, I also had a MRI of My lumbar spine along with xray both normal. Would the normal M spike or spep make a plasmacytoma less likely TY

[Dr. Edward Libby]

Re: bone lesion

by Dr. Edward Libby on Mon Jul 18, 2011 10:27 am

Hello,
24% to 72% of patients with a solitary bone plamsacytoma have an m-spike. To check for an m-spike both a serum and urine electrophoresis must be tested. Serum free light chain testing has largely replaced the 24 hour urine electophoresis. The fact that you do not have an m-spike doesnt really help decide whether or not this is a plasmacytoma.

However, virtually all plasmacytomas have a lytic appearance on regular XRAYs. If this lesion is not lytic is almost certainly is not a plasmacytoma.

[loured]

Re: bone lesion

by loured on Mon Jul 18, 2011 7:59 pm

Thank you for your response Doctor. The lesion did not show up on the xray, it only appeared on the MRI. The MRI described the lesion as non specific. Could the MRI tell if the lesion is lytic or not??? The MRI was a High field T3 machine.

[elibby]

Re: bone lesion

by elibby on Wed Jul 20, 2011 12:08 am

Generally plain xrays of the bone are the routine way to determine whether or not a lesion is "lytic". The MRI report of "nonspecific" does not suggest myeloma to me.