Il Plasmocitoma: Aspetti Clinico - Radiologici

Abstract

The examination of 18 subjects affected with plasmocytoma showed that the radiological appearance of a punched out osteolytic lacuna is not seen in more than the 20 per cent of the cases. Other radiological pictures (diffuse osteoporosis, cystic and polycystic aspect, perifocal bone thickening) are frequentily observed and, occasionally, the X-ray examination is negative. Fractures have been observed in the 30 per cent of the cases. The differential diagnosis has to be done with: osteoporosis, bony pseudo-lacunae, Brodie's abscess, Ewing tumour, solitary cyst, eosinophilic granuloma, giant cell tumour, bony metastases and fibrous dysplasiae. Stress is laid on the diagnostical value of the marrow biopsy, the seroprotein electrophoretical study, the search of Bence Jones bodies in the urine and the test for P32 urinary output, which was carried out on 5 patients and gave results not always uniform. From the therapeutical viewpoint, scarce results have been obtained with cortisone and X rays, whereas a nitrogen mustard derivative (endoxan) proved to be quite ineffective. 8 cases were treated with P32: in 3 of them the painful symptomatology disappeared for a period ranging from 2 months to 1 year, whereas the bone lesions remained unmodified. On the other hand, a reduction of bone lesions with a slow re-calcification was obtained in one case treated with telecobaltotherapy.