Hi all.
I am smoldering and just had MRI which indicated 8 millimeter Tl and T2 hyperintense lesion within T4. Doctor says this is not from myeloma as they are lytic lesions, i.e. holes.
Is this so, and must I experience anemia and high calcium if actually from myeloma. I have rib and lumbar pain which is increasing all the time. In other words, can the myeloma lesions precede anemia and high calcium?
Smarty
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smarty - Name: Marti
- Who do you know with myeloma?: myself Smoldering Myeloma
- When were you/they diagnosed?: May 1, 2015
- Age at diagnosis: 76
Re: Can lesions precede anemia & high calcium at diagnosis?
Smarty,
Your doctor's explanation doesn't sound quite right to me. Lytic lesions (i.e. lesions that appear as holes on a radiological image due to osteolytic damage) are a common manifestation of symptomatic multiple myeloma. One can develop lytic lesions in the absence of the the "CRA" in "CRAB" (hypercalcemia, renal impairment, anemia, bone damage).
Given this recent MRI finding and your other pain, I would be pushing for a PET/CT to see if you have any lesions elsewhere and to verify if they are cancerous or not.
Your doctor's explanation doesn't sound quite right to me. Lytic lesions (i.e. lesions that appear as holes on a radiological image due to osteolytic damage) are a common manifestation of symptomatic multiple myeloma. One can develop lytic lesions in the absence of the the "CRA" in "CRAB" (hypercalcemia, renal impairment, anemia, bone damage).
Given this recent MRI finding and your other pain, I would be pushing for a PET/CT to see if you have any lesions elsewhere and to verify if they are cancerous or not.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Can lesions precede anemia & high calcium at diagnosis?
Hi Multibility,
Thanks for response. I did not explain myself well. Doctor said my lesions are not holes (which would indicate multiple myeloma). But was described as 8 millimeter T1 and T2 hyperintense lesion representing a hemangioma. In researching this I am not sure if possibly from multiple myeloma.
I have 1.5 M-spike, free light chain ratio of 10, total IgG had been about 1800 but just dropped to 1520 Mg/dl. This now makes my healthy IgG 120, which is very low, but not experiencing infection.
Only change is more total spine pain.
Thanks again.
Marti
Thanks for response. I did not explain myself well. Doctor said my lesions are not holes (which would indicate multiple myeloma). But was described as 8 millimeter T1 and T2 hyperintense lesion representing a hemangioma. In researching this I am not sure if possibly from multiple myeloma.
I have 1.5 M-spike, free light chain ratio of 10, total IgG had been about 1800 but just dropped to 1520 Mg/dl. This now makes my healthy IgG 120, which is very low, but not experiencing infection.
Only change is more total spine pain.
Thanks again.
Marti
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smarty - Name: Marti
- Who do you know with myeloma?: myself Smoldering Myeloma
- When were you/they diagnosed?: May 1, 2015
- Age at diagnosis: 76
Re: Can lesions precede anemia & high calcium at diagnosis?
Smarty,
I agree totally with Multibilly; you need to get a PET/CT scan to get a proper diagnosis.
I agree totally with Multibilly; you need to get a PET/CT scan to get a proper diagnosis.
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coachhoke - Name: coachhoke
- When were you/they diagnosed?: Apri 2012
- Age at diagnosis: 71
Re: Can lesions precede anemia & high calcium at diagnosis?
Hi Smarty,
I agree with previous comments and am confused by your doctor's comment. I would consult with a myeloma specialist if you have not done so.
My husband has light chain myeloma. He did not have high calcium, anemia or renal problems at diagnosis or since. He did however have lytic lesions. He only had the B in CRAB.
I concur that a PET/CT is warranted as you may have lesions in other areas along with bone marrow biopsy
Also labs and a 24 urine would give you a good picture of what is going on.
Good luck to you,
Kerri
I agree with previous comments and am confused by your doctor's comment. I would consult with a myeloma specialist if you have not done so.
My husband has light chain myeloma. He did not have high calcium, anemia or renal problems at diagnosis or since. He did however have lytic lesions. He only had the B in CRAB.
I concur that a PET/CT is warranted as you may have lesions in other areas along with bone marrow biopsy
Also labs and a 24 urine would give you a good picture of what is going on.
Good luck to you,
Kerri
Re: Can lesions precede anemia & high calcium at diagnosis?
Hi Keri,
Thanks for your reply. Did you understand that my lesions were not holes? My first note was confusing and I am sorry for misunderstanding.
My doctors comments were that since not holes could not be advance to multiple myeloma but still smoldering.
I had labs. 1.5 M-spike, just over 10 kappa-lambda ratio, 1520 IgG, which is 300 drop since last reading. Had bone marrow biopsy May, 2015 and it showed 18% plasma cells by aspirate with 10-20% plasma cells by outside CD138.
Please let me know if you still feel I need further tests. Thought I understood this but always something else confusing. Marti
Thanks for your reply. Did you understand that my lesions were not holes? My first note was confusing and I am sorry for misunderstanding.
My doctors comments were that since not holes could not be advance to multiple myeloma but still smoldering.
I had labs. 1.5 M-spike, just over 10 kappa-lambda ratio, 1520 IgG, which is 300 drop since last reading. Had bone marrow biopsy May, 2015 and it showed 18% plasma cells by aspirate with 10-20% plasma cells by outside CD138.
Please let me know if you still feel I need further tests. Thought I understood this but always something else confusing. Marti
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smarty - Name: Marti
- Who do you know with myeloma?: myself Smoldering Myeloma
- When were you/they diagnosed?: May 1, 2015
- Age at diagnosis: 76
Re: Can lesions precede anemia & high calcium at diagnosis?
Marti,
You also complain of rib pain. It just makes sense to me to get a PET/CT to see what is causing the rib pain, to verify that the finding on your spine is not cancerous and to see if you might have any problems elsewhere.
You also complain of rib pain. It just makes sense to me to get a PET/CT to see what is causing the rib pain, to verify that the finding on your spine is not cancerous and to see if you might have any problems elsewhere.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Can lesions precede anemia & high calcium at diagnosis?
Thank you Multibily. I will consider and talk with my doctor, who is a myeloma specialist. She is at the University of North Carolina.
As I am 78 years old, and even though except for smoldering, spinal disk deterioration following fusion, am in excellent health. MRI was 2 and 1/4 hours, which was hard on my back. PET would be worse and what could I do anyway. I would not qualify for aggressive treatment and would probably choose quality of life over time. My heart goes out to all you younger ones who should not have to have such difficult choices to make.
Thank you again for your opinion, which I know is right, but probably not for me.
Marti
As I am 78 years old, and even though except for smoldering, spinal disk deterioration following fusion, am in excellent health. MRI was 2 and 1/4 hours, which was hard on my back. PET would be worse and what could I do anyway. I would not qualify for aggressive treatment and would probably choose quality of life over time. My heart goes out to all you younger ones who should not have to have such difficult choices to make.
Thank you again for your opinion, which I know is right, but probably not for me.
Marti
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smarty - Name: Marti
- Who do you know with myeloma?: myself Smoldering Myeloma
- When were you/they diagnosed?: May 1, 2015
- Age at diagnosis: 76
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