Hi all,
I'm just curious if extraosseous and extramedullary are different ways of saying the same thing.
My husband now has myeloma activity outside the marrow, but it still only involves his bones (per PET scan). The radiologist noted that there are no extraosseous lesions, so I'm hoping this also means that this activity on his bones is not considered extramedullary manifestation of his disease.
Thank you.
Laurie
Forums
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lwem - Name: Laurie
- Who do you know with myeloma?: husband
- When were you/they diagnosed?: April 2015
- Age at diagnosis: 68
Re: Do extraosseous and extramedullary mean the same thing?
Hi Laurie,
When it comes to describing myeloma activity, my understanding is that "extraosseous" generally means the same thing as "extramedullary" (although their exact definitions are slightly different).
Lesions due to myeloma that are within the bone marrow are known as focal lesions. Lesions due to myeloma that are found on the hard, outer area of the bone are known as lytic lesions. It sounds like your husband may be developing lytic lesions or that previously existing lytic lesions have been detected by the PET/CT scan. If there were active cancer activity within the lesion (i.e. the PET/CT registered FDG uptake and the lesion "lit up" on the scan), the radiologist would note it. If I read a couple of your earlier posts, it appears that your husband has had lytic lesions since the time of his diagnosis.
In any case, it's good news that he doesn't have extramedullary disease.
When it comes to describing myeloma activity, my understanding is that "extraosseous" generally means the same thing as "extramedullary" (although their exact definitions are slightly different).
Lesions due to myeloma that are within the bone marrow are known as focal lesions. Lesions due to myeloma that are found on the hard, outer area of the bone are known as lytic lesions. It sounds like your husband may be developing lytic lesions or that previously existing lytic lesions have been detected by the PET/CT scan. If there were active cancer activity within the lesion (i.e. the PET/CT registered FDG uptake and the lesion "lit up" on the scan), the radiologist would note it. If I read a couple of your earlier posts, it appears that your husband has had lytic lesions since the time of his diagnosis.
In any case, it's good news that he doesn't have extramedullary disease.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Do extraosseous and extramedullary mean the same thing?
Multibilly,
Thank you so much for this clarification. It makes sense! These are new lytic lesions found on the PET-CT and you are correct that he has had many since diagnosis on his spine and sacrum.
I appreciate your help.
Laurie
Thank you so much for this clarification. It makes sense! These are new lytic lesions found on the PET-CT and you are correct that he has had many since diagnosis on his spine and sacrum.
I appreciate your help.
Laurie
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lwem - Name: Laurie
- Who do you know with myeloma?: husband
- When were you/they diagnosed?: April 2015
- Age at diagnosis: 68
Re: Do extraosseous and extramedullary mean the same thing?
Laurie,
Just wanted to chime in as well. Your question refers to a common source of confusion. Unfortunately, definitions have not always been uniform across studies and reports. In general, "extramedullary disease' has been used to refer BOTH to organ/tissue involvement with myeloma (via spread through bloodstream) AND 'paraskeletal' disease, meaning disease that starts in the bone, but grows outwards to the tissues/organs.
Both definitions are reasonable, but the first could also be called 'extraosseous' (totally outside of the bone), whereas the second is truly bone derived with local spread.
All in all, it seems that when myeloma grows completely removed from bone (e.g. in organs such as the liver), this is a higher risk situation, i.e., higher risk than myeloma that grows out from a bone into the surrounding organs/tissues. This makes some sense on a 'molecular' basis because plasma cells that figure out how to grow totally away from the bones where they come form, tend to be more aggressive (genetically speaking).
Hope this clarifies a bit further.
Dr. Hoffman
Just wanted to chime in as well. Your question refers to a common source of confusion. Unfortunately, definitions have not always been uniform across studies and reports. In general, "extramedullary disease' has been used to refer BOTH to organ/tissue involvement with myeloma (via spread through bloodstream) AND 'paraskeletal' disease, meaning disease that starts in the bone, but grows outwards to the tissues/organs.
Both definitions are reasonable, but the first could also be called 'extraosseous' (totally outside of the bone), whereas the second is truly bone derived with local spread.
All in all, it seems that when myeloma grows completely removed from bone (e.g. in organs such as the liver), this is a higher risk situation, i.e., higher risk than myeloma that grows out from a bone into the surrounding organs/tissues. This makes some sense on a 'molecular' basis because plasma cells that figure out how to grow totally away from the bones where they come form, tend to be more aggressive (genetically speaking).
Hope this clarifies a bit further.
Dr. Hoffman
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Dr. James Hoffman - Name: James E. Hoffman, M.D.
Beacon Medical Advisor
4 posts
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