PMID- 37000077
OWN - NLM
STAT- MEDLINE
DCOM- 20230404
LR  - 20230916
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 102
IP  - 13
DP  - 2023 Mar 31
TI  - Plasma cell myeloma initially diagnosed as light-chain deposition disease on 
      liver biopsy: A case report and literature review.
PG  - e33406
LID - 10.1097/MD.0000000000033406 [doi]
LID - e33406
AB  - RATIONALE: Light-chain deposition disease (LCDD) is a rare condition 
      characterized by the abnormal deposition of monoclonal light chains (LCs) in 
      multiple organs, leading to progressive organ dysfunction. Herein, we report a 
      case of plasma cell myeloma initially diagnosed as LCDD on liver biopsy performed 
      for prominent cholestatic hepatitis. PATIENT CONCERNS: A 55-year-old Korean man 
      complained of dyspepsia as the main symptom. On abdominal computed tomography 
      performed at another hospital, the liver showed mildly decreased and 
      heterogeneous attenuation with mild periportal edema. Preliminary liver function 
      tests revealed abnormal results. The patient was treated for an unspecified liver 
      disease; however, his jaundice gradually worsened, prompting him to visit our 
      outpatient hepatology clinic for further evaluation. Magnetic resonance 
      cholangiography revealed liver cirrhosis with severe hepatomegaly of unknown 
      cause. A liver biopsy was performed for the diagnosis. Hematoxylin and eosin 
      staining revealed diffuse extracellular amorphous deposits in perisinusoidal 
      spaces with compressed hepatocytes. The deposits, which morphologically resembled 
      amyloids, were not stained by Congo red but stained strongly positive for kappa 
      LCs and weakly positive for lambda LCs. DIAGNOSES: Therefore, the patient was 
      diagnosed with LCDD. Further systemic examination revealed a plasma cell myeloma. 
      INTERVENTIONS: Fluorescence in situ hybridization, cytogenetics, and 
      next-generation sequencing tested in bone marrow showed no abnormalities. The 
      patient initially received bortezomib/lenalidomide/dexamethasone as the treatment 
      regimen for plasma cell myeloma. OUTCOMES: However, he died shortly thereafter 
      because of coronavirus disease 2019 complications. LESSONS: This case 
      demonstrates that LCDD may present with sudden cholestatic hepatitis and 
      hepatomegaly, and may be fatal if patients do not receive appropriate and timely 
      treatment because of delayed diagnosis. Liver biopsy is useful for the diagnosis 
      of patients with liver disease of unknown etiology.
CI  - Copyright (c) 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Jeong, Ji Yun
AU  - Jeong JY
AD  - Department of Pathology, School of Medicine, Kyungpook National University, 
      Kyungpook National University Chilgok Hospital, Daegu, South Korea.
FAU - Yang, Hyeon Tae
AU  - Yang HT
AD  - Department of Pathology, School of Medicine, Kyungpook National University, 
      Kyungpook National University Hospital, Daegu, South Korea.
FAU - Cho, Seung Hyun
AU  - Cho SH
AD  - Department of Radiology, School of Medicine, Kyungpook National University, 
      Kyungpook National University Chilgok Hospital, Daegu, South Korea.
FAU - Lee, Yu Rim
AU  - Lee YR
AD  - Department of Internal Medicine, School of Medicine, Kyungpook National 
      University, Kyungpook National University Chilgok Hospital, Daegu, South Korea.
FAU - Kim, Jinhee
AU  - Kim J
AD  - Department of Pathology, School of Medicine, Kyungpook National University, 
      Kyungpook National University Chilgok Hospital, Daegu, South Korea.
FAU - Kang, Min Kyu
AU  - Kang MK
AD  - Department of Radiation Oncology, School of Medicine, Kyungpook National 
      University, Kyungpook National University Chilgok Hospital, Daegu, South Korea.
FAU - Hong, Jihoon
AU  - Hong J
AD  - Department of Radiology, School of Medicine, Kyungpook National University, 
      Kyungpook National University Chilgok Hospital, Daegu, South Korea.
FAU - Moon, Joon Ho
AU  - Moon JH
AD  - Department of Hematology/Oncology, School of Medicine, Kyungpook National 
      University, Kyungpook National University Chilgok Hospital, Daegu, South Korea.
FAU - Seo, An Na
AU  - Seo AN
AUID- ORCID: 0000-0001-6412-3067
AD  - Department of Pathology, School of Medicine, Kyungpook National University, 
      Kyungpook National University Chilgok Hospital, Daegu, South Korea.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - F0P408N6V4 (Lenalidomide)
RN  - 69G8BD63PP (Bortezomib)
RN  - 7S5I7G3JQL (Dexamethasone)
SB  - IM
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Multiple Myeloma/complications/diagnosis
MH  - Hepatomegaly
MH  - In Situ Hybridization, Fluorescence
MH  - *COVID-19/complications
MH  - *Liver Diseases/diagnosis/complications
MH  - Lenalidomide
MH  - Bortezomib/therapeutic use
MH  - Dexamethasone
MH  - Biopsy
PMC - PMC10063314
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2023/04/01 06:00
MHDA- 2023/04/04 06:42
PMCR- 2023/03/31
CRDT- 2023/03/31 10:23
PHST- 2023/04/04 06:42 [medline]
PHST- 2023/03/31 10:23 [entrez]
PHST- 2023/04/01 06:00 [pubmed]
PHST- 2023/03/31 00:00 [pmc-release]
AID - 00005792-202303310-00031 [pii]
AID - 10.1097/MD.0000000000033406 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2023 Mar 31;102(13):e33406. doi: 
      10.1097/MD.0000000000033406.