multiple myeloma

 CRAB: calcium, renal insufficiency, anemia, bone abnormality

 CT도 잘 보면 cell infiltration이 보인다.

 여러 pattern의 MRI, normal도 1/3이다.

 Grade system이고

 10%는 extraaxial skeleton만 involve한다. 따라서 whole body를 검사할 필요가 있다.

예전에 쓰던 stage는 더이상 쓰지 않고 새로운 stage system을 쓰는데 이것은 whole body MRI로 myeloma의 extent를 한번에 알아내려는 것이다.

nnstage A disease is indicated by a serum creatinine level of less than 2.0 mg/dL and no imaging findings of extramedullary involvement

nstage B disease is characterized by a serum creatinine level of more than 2.0 mg/dL, imaging findings of extramedullary involvement, or both.

n† Indicators of end organ damage are an elevated blood calcium level, renal insufficiency, anemia, and bone abnormalities.

n‡ In MGUS, unlike multiple myeloma, no evidence of bone marrow disease is seen at imaging. In multiple myeloma, the degree of diffuse marrow infiltration is assessed on T1-weighted images and categorized as mild (micronodular or “salt-and-pepper”), moderate (marrow signal intensity lower than normal but still contrasting with that of the intervertebral disks), or severe (marrow signal intensity equal to or lower than signal intensity of the disks).

n§ Smoldering multiple myeloma is classified as stage IA disease.

survival 및 prognosis가 매우 다양하고 치료방법도 다양한데 이 모든 것이 myeloma의 extent에 달려 있다.